Temporal Trends Research Articles

Long-term lung cancer risk in breast cancer survivors: A 40-year comprehensive analysis.

e12501 Background: Breast cancer survivors face an increased risk of secondary malignancies, with lung cancer being one of the most concerning long-term adverse effects. This study provides a comprehensive analysis of the incidence and survival outcomes of lung cancer in breast cancer patients treated with postoperative radiotherapy, emphasizing long-term risk assessment and temporal trends over four decades. Methods: This retrospective cohort study utilized data from the Breast Cancer Health Database, encompassing 304,550 breast cancer patients diagnosed between 1979 and 2020. The association between postoperative radiotherapy and secondary lung cancer risk was evaluated using Cox proportional hazards models, adjusting for confounding variables including surgery, chemotherapy, immunotherapy, endocrine therapy, and targeted therapy. Kaplan-Meier survival analyses were conducted to evaluate overall survival, stratified by treatment modalities and diagnosis periods. Temporal trends in survival and treatment efficacy were analyzed across decades to assess the evolution of risk-benefit profiles. Results: Among the cohort, 3,112 patients were diagnosed with secondary lung cancer. Postoperative radiotherapy was associated with a significant increase in lung cancer risk (hazard ratio [HR]: 1.61; 95% confidence interval [CI]: 1.414–1.691; p < 0.0001). The median time to secondary lung cancer diagnosis was 124 months, with risk influenced by radiation exposure levels. While radiotherapy was associated with a heightened lung cancer risk, it concurrently demonstrated improved overall survival in breast cancer patients. Temporal analysis revealed enhanced survival benefits for radiotherapy recipients during more recent periods (2010–2017) compared to earlier decades, reflecting advancements in radiotherapy techniques. Stratified analysis indicated that treatment combinations influenced outcomes: chemotherapy was associated with a reduced lung cancer risk (HR: 0.845; p = 0.0001), whereas targeted therapy significantly increased risk (HR: 2.033; p < 0.0001). Conclusions: Postoperative radiotherapy in breast cancer survivors is associated with an elevated long-term risk of secondary lung cancer but offers substantial overall survival benefits. Temporal improvements in radiotherapy delivery and personalized treatment strategies have likely contributed to a more favorable risk-benefit profile in recent years. These findings underscore the critical need for long-term surveillance and the development of tailored therapeutic approaches to balance the risks and benefits of radiotherapy in breast cancer management.

Temporal trends in myeloproliferative neoplasms–related mortality in the United States over the last three decades: An analysis of the Global Burden of Disease database.

e18601 Background: Myeloproliferative neoplasms (MPNs) are a group of hematologic malignancies associated with substantial morbidity and mortality. Understanding long-term mortality trends is crucial for guiding healthcare strategies and assessing the impact of advancements in diagnosis and treatment. Methods: Mortality data, including age-standardized morality rate, for MPNs in the United States from 1990 to 2019 were obtained from the Global Burden of Disease database. Temporal trends were analyzed using Joinpoint regression analysis by calculating the Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC). Results: Total Mortality: An estimated total of 222,511 MPN-related deaths were reported from 1990 to 2019. Overall Trends: MPN-related mortality exhibited an overall increasing trend (AAPC: 0.102, 95% CI: 0.067 to 0.133; p < 0.001). Mortality initially rose during 1990 to 2001 (APC: 0.67; p = 0.0004), followed by a decline from 2001 to 2004 (APC: -1.02; p = 0.037), and a subsequent increase from 2004 to 2011 (APC: 0.80; p = 0.037). A stabilization phase occurred from 2011 to 2015 (APC: -0.45; p > 0.05), followed by a significant decline from 2015 to 2019 (APC: -1.44%; p < 0.001). Gender-Specific Trends: Females: Mortality rates initially increased (APC: 0.85 from 1990 to 2001; p < 0.001), followed by declines from 2001 to 2004 (APC: -1.17%; p < 0.001) and fluctuations in subsequent years, with a final significant decline from 2016 to 2019 (APC: -1.91; p < 0.001). The overall AAPC for females was 0.053%, which was not statistically significant (p = 0.323). Males: Mortality rates noticed an initial increase in the early 1990s (APC: 0.90 from 1990 to 1994; p < 0.001), followed by a stabilization 1994 to 2001 (APC: 0.04; p > 0.05), and then rose again from 2001 to 2005 (APC: 1.01; p < 0.001) and 2005 to 2010 (APC: 1.34; p < 0.001). A significant decline followed from 2014 to 2019 (APC: -1.46; p < 0.001), with an overall AAPC of -0.07% (95% CI: -0.108 to -0.032; p < 0.05). Conclusions: Over the last three decades, MPN-related mortality in the United States has demonstrated an initial increase followed by periods of stabilization and significant declines, particularly after 2014. Both males and females experienced mortality reductions in recent years, likely reflecting advancements in therapeutic strategies and improved disease management. Further investigations into gender-specific and global trends may provide additional insights into optimizing treatment and care for MPN patients.

Assessing trends in patients undergoing recurrent CT examinations and cumulative doses.

Assessing trends in patients undergoing recurrent CT examinations and cumulative doses.

Temporal and regional mortality trends due to pulmonary embolism in female patients with genital cancers in the United States from 1999 to 2020.

5617 Background: The involvement of pulmonary vessels by tumor emboli has been described from different primary sites of malignancy. Pulmonary embolism (PE) is a severe and potentially fatal complication in patients with female genital cancers, including ovarian, cervical, uterine, and vulvar malignancies. These cancers, along with associated treatments such as major abdominal surgery, chemotherapy, and hormone therapy, significantly increase the risk of venous thromboembolism (VTE), including PE. While previous studies detail the advancements in cancer detection and treatment, temporal and regional trends of PE-related mortality among female genital cancer patients remain poorly characterized. Methods: This retrospective study analyzes national mortality data from the CDC WONDER database to assess mortality trends from 1999 to 2020 across different demographic subgroups in the United States. Patients with a known history of genital cancer were identified and PE related mortality data was retrieved. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated further stratified based on sex, age (15-64 years and >64 years), race and census region. Rstudio was used to perform t-test and Mann Kendall test. Results: From 1999 to 2020, a total of 13,692 deaths were reported in female genital cancer associated pulmonary embolism in the US (AAPC: 0.421 (95% CI: 0.414-0.428)). The AAMR has risen from 0.363 in 1999 to 0.590 in 2020, indicating a worsening trend over the study period (τ: 0.680, p<0.001). AAMR varied greatly by region, with the Northeast having the highest AAMR (9.928). This was followed by the West (0.488), Midwest (0.43) and South (0.366). Black females had consistently higher AAMR than white females, with rates of 0.763 vs. 0.329 in 1999 and 0.976 vs. 0.523 in 2020, respectively. Females older than 65 years demonstrated a much higher total AAMR (1.506) compared to females between the ages of 15 and 65 (0.212) (p<0.001). Within the age group of 15-25 years, black females had higher AAMRs compared to white female (p<0.001). Black females of the age group >65 years demonstrated much higher mortality (total AAMR: 2.745) than white females of the same age group (1.419), and the highest AAMR overall (P<0.001). Conclusions: The analysis of AAMR for female genital cancer associated pulmonary embolism highlights a concerning disparity in this dangerous cancer related complication, particularly after 2015. This underscores the need for greater attention to be directed towards reproductive health and cancer related complications faced by black women and to address systematic inequalities in intervention and healthcare access. This can improve early detection and timely interventions in order to reduce mortality and improve outcomes for these patients.

Temporal trends in the prevalence and burden of atopic dermatitis worldwide from 1990 to 2021.

Temporal trends in the prevalence and burden of atopic dermatitis worldwide from 1990 to 2021.

Clusters of high transmission risk and time series for Equine Infectious Anemia in Brazil.

Clusters of high transmission risk and time series for Equine Infectious Anemia in Brazil.

Temporal trends in opioid prescription fills following cancer-directed surgery.

11099 Background: Postoperative pain is a common complication of cancer surgery. Opioid prescribing has declined dramatically since the early 2010’s; however, little is known about trends in opioid prescribing following cancer-directed surgeries. Methods: Using administrative data for 100% Medicare fee-for-service beneficiaries enrolled in parts A, B, and D, we identified initial episodes of cancer-directed surgeries from 2012-2021 among adults who survived > 30d after surgery and were discharged home. We used Part D claims to identify early postop opioid fills, defined as prescriptions filled in the 30d after surgery for outpatient surgeries, and in the 30d following hospital discharge for inpatient surgeries. We described opioid fills, median dose, pill counts, and the proportion with subsequent fills overall and annually. Results: We identified 981,702 episodes of cancer directed surgeries, most often for breast (38%), colorectal (15%), prostate (13%), and lung (10%) cancers. Patients’ mean age was 73(SD,8), 36% were male, 83% White, 8% Black, 4% Hispanic, and 2% Asian. Overall, 66.6% of patient episodes had ≥1 postoperative opioid fill, declining from 70.7% in 2012 to 59.3% in 2021. Among episodes with ≥1 opioid fill, the median dose of the first opioid fill declined from 225 (IQR:150,300) morphine milligram equivalents (MMEs) to 100 (IQR:75,150) MMEs between 2012-2021, and the total dose of all fills in 30d fell from 250 (IQR:150,450) MMEs to 112.5 (IQR:75,210) MMEs. Median pill counts for the first short-acting opioid fill declined from 30(IQR:30,40) to 18(IQR:10,25) over the study. Among episodes with ≥1 short-acting opioid fill, the proportion with subsequent short-acting opioid fills declined from 30.7% to 17.8%. Conclusions: Medicare beneficiaries undergoing cancer-directed surgeries have experienced steep declines in prescription opioid medication fills in the postoperative period. Future work is needed to understand potential impacts of declining postoperative opioid prescribing on outcomes such as uncontrolled pain, pain-related emergency department visits, persistent opioid use, and development of opioid use disorders. Support: R01CA279414.

Therapeutic decisions and outcome of patients with stage I testicular germ cell tumor: Single-centre experience.

5029 Background: Testis cancer (TC) is the most common solid neoplasm affecting men aged 15 to 40, with most of diagnosis occurring at stage I. Despite excellent prognosis, optimal post-surgical management remains controversial, comprising adjuvant therapy (AT) or active surveillance (AS). Methods: Our study aimed to compare relapse-free survival (RFS) in patients (pts) with stage I TC undergoing AT [chemotherapy (CT) or radiotherapy (RT)], versus AS, between 2000 and 2023. Evolution of AT choices for seminomas was evaluated over different time periods (before 2014, 2014-2018, after 2018). Clinical histories of stage I TC treated at our institution were retrospectively collected. Traditional histopathological prognostic factors for relapse were assessed, and seminomas were reclassified according to the new EAU risk group classification. Overall survival (OS) was a secondary endpoint. Pts with inadequate follow-up, insufficient information, or histologies other than seminoma and nonseminoma were excluded. Results: Out of 240 cases, 184 (129 seminomas, 54 non-seminomas, 1 burned-out tumor) were eligible. AT was administered to 58.1% of seminomas and 57.4% of nonseminomas. In seminomas, AT was represented by CT in 40.3% and RT in 17.8% of cases. RT administration significantly decreased over time, representing 66.7% of AT before 2014, 9.1% between 2014 and 2018, and 0% after 2018. With a median follow-up of 56.9 months, 5-yr RFS rate was 94.6% and 84.7% for pts undergoing AT and AS, respectively (p=0.005). Particularly, 5-yr RFS rate was 92.5% vs 86.7% in seminomas (p=0.07), and 100% vs 79.9% in nonseminomas (p=0.015). Proportion of seminomas undergoing AT was 20.7% among those with T<4 cm and no rete testis invasion, 56.4% among those with 1 risk factor, and 82.2% among pts with 2 risk factors. AT was received by 3.2% and 96.8% of nonseminomas without and with lymphovascular invasion, respectively. In the new EAU classification, 31.4%, 48.8% and 19.8% of seminomas were classified into the very low, low, and high risk categories (8 cases not evaluable). Compared to the traditional classification, a lower proportion of pts resulted in the poorest risk category (19.8% vs 34.9%). AT receipt significantly increased with risk: very low 27.0%, low 67.8%, high 83.3% (p<0.001). 5-yr OS rate was 98.1% (99.1% in seminoma and 95.1% in nonseminoma). Conclusions: AT was associated with higher RFS rates across both histological types. AS and AT are both associated to excellent survival. A temporal trend in reduction of RT was observed. Further evaluations are needed to individualize treatment decisions. Histopathological risk factors and the new EAU risk classification provide valuable prognostic information, aiding in treatment stratification. Additionally, the EAU risk group classification emerges as a potential tool to better stratify seminoma pts and support the implementation of AS in lower risk categories.

Temporal trends in Burkitt lymphoma–related mortality in the United States over the last three decades: An analysis of the Global Burden of Disease database.

e19074 Background: Burkitt lymphoma (BL) is a rare but aggressive form of non-Hodgkin lymphoma, with significant mortality implications in the United States. Evaluating long-term mortality trends provides valuable insights into the impact of advances in treatment and healthcare strategies. Methods: Mortality data for Burkitt lymphoma in the United States from 1990 to 2019 were obtained from the Global Burden of Diseases database. Joinpoint regression analysis was utilized to assess temporal trends by calculating the Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC). Results: A total of 11,397.32. deaths due to Burkitt lymphoma were reported over the study period. Overall Trends: Mortality rates showed an initial gradual increase (APC: 1.02% from 1990–1997; p < 0.001), followed by a more prominent rise (APC: 9.64% from 1997–2000; p < 0.001), and a moderate increase from 2000–2005 (APC: 2.76%; p < 0.001). Subsequently, a significant decline in mortality was observed (APC: -1.41% from 2005–2019; p < 0.001). The overall AAPC for the period was 0.986% (95% CI: 0.9154 to 1.0635; p < 0.001). Gender-Specific Trends: Females: Mortality increased significantly in the early years (APC: 2.56% from 1990–1997; p < 0.001), followed by a more significant increase (APC: 9.69% from 1997–2000; p < 0.001) that then dropped to a moderate rise (APC: 2.99% from 2000–2003; p < 0.001), with subsequent stabilization in the rates for the period 2004-2006. A subsequent decline in the rates was later witnessed(APC: -1.38% from 2008–2019; p < 0.001). The overall AAPC for females was 1.382% (95% CI: 1.2743 to 1.4869; p < 0.001). Males: Mortality rates witnessed an increase (APC: 1.09% from 1990–1993; p < 0.05), followed by a steep rise (APC: 8.59% from 1997–2000; p < 0.001), and eventually a gradual decline in later years (APC: -1.63% from 2006–2019; p < 0.001). The overall AAPC for males was 0.654% (95% CI: 0.5956 to 0.7182; p < 0.001). Conclusions: Burkitt lymphoma-related mortality in the United States exhibited a significant increase in the late 1990s, followed by a decline in recent years, reflecting improvements in early detection and treatment options. Gender differences in mortality trends highlight the need for further investigation into treatment effectiveness and access to care. Future research should focus on optimizing treatment strategies and addressing disparities to further reduce BL mortality.

Trends in Drug Claims for Non-Specific Low Back Pain in Québec, 1997 to 2018.

The aim of this study was to describe temporal trend of drugs claims after an episode of non-specific low back pain in Québec between 1997 and 2018, by pharmacological class. Data came from the PROspective Québec study on work and health (PROQ), the Régie de l'assurance maladie du Québec (RAMQ) and Québec hospital services (Med-Echo). RAMQ common denomination codes were used to identify the types of medication claimed for an episode of non-specific low back pain. Multivariate log-binomial regression models were used to evaluate temporal trends in claims for the main pharmacological classes, taking into account dependence between multiple episodes. A total of 5214 episodes of non-specific low back pain were identified in 1658 people between 1997 and 2018. The mean age at the first medical service for low back pain was 64.1years (standard deviation: 8.3years). Results show a significant increase in opioid claims between 1997 and 1998 (4.1%) and 2009-2010 (12.7%) (p for trend=0.0008), anticonvulsants between 1997 and 1998 (0.0%) and 2011-2012 (10.5%) (p for trend=0.0002), and myorelaxants between 1997 and 1998 (2.0%) and 2009-2010 (8.8%) (p for trend<0.0001), but no significant change in claims for antidepressants between 1997 and 1998 (0.5%) and 2016-2017 (2.6%) (p for trend=0.5508). Claims for opioids, anticonvulsants and myorelaxants for non-specific low back pain showed significant upward changes between 1997 and 2018 in Québec, in contrast to antidepressants. These temporal variations in claims were different for each group of drugs, with a greater variation for anticonvulsants.

Cross-state variations and temporal trends in tracheal, bronchus and lung cancer burden in India from 1990-2021: Mortality projections to 2050.

e22520 Background: Tracheal, Bronchus and Lung Cancer (TBLc) is the 2nd leading cause of death and 3rd leading cause of disability in India, with rising incidence driven by tobacco use, environmental pollution, and regional disparities. Methods: We estimated incidence, prevalence, disability adjusted life years (DALYs), years lived with disability (YLDs) due to TBLc analyzed by age, sex, year and location across India and its territories from 1990-2021 using standardized global burden of disease study 2021 methodology. We projected death due to LC up to 2050 using regression framework. Results: The annual percentage change(APC) in age-standardized incidence rate(ASIR) increased by 0.72%, prevalence rate(ASPR) by 0.78%, mortality rate(ASMR) by 0.68%, disability-adjusted life years(DALYs) rate (ASDALR) by 0.57%, and years lived with disability(YLDs) rate (ASYLDR) by 0.71% from 1990 to 2021. At the sub-national level, the highest increase in APC for ASYLDR was observed in Uttarakhand (1.46%), Gujarat (1.41%), and Uttar Pradesh (U.P.) (1.31%). The highest APC for ASIR was recorded in Uttarakhand (1.56%), U.P. (1.4%), and Gujarat (1.35%) during the same period. For ASMR, the highest increases in APC were noted in Uttarakhand (1.5%),U.P. (1.38%), and Gujarat (1.3%). The APC in ASMR due to TBLc attributable to metabolic risk factors increased by 1.3%, followed by environmental and occupational risk factors (0.2%) and behavioral risk factors (0.05%) from 1990 to 2021. Age-wise, the highest APC in death count was observed in individuals aged 95+ years (8.12%), followed by 90–94 years (7.14%), 85–89 years (6.60%), 80–84 years (6.10%), 75–79 years (4.94%), and 70–74 years (4.24%), with APC decreasing progressively in younger age groups during the study period. Gender-wise, the APC in ASMR was higher in females compared to males (1.82% vs. 0.34%), as was the APC in ASIR (1.9% vs. 0.45%) and ASDALR (1.74% vs. 0.3%) from 1990 to 2021. The total number of deaths due to TBLc is projected to rise by 155,577 (95% uncertainty interval: 99,007–223,304), with the ASMR expected to increase by 5.79 (95% uncertainty interval: 3.99–7.81) per person by 2050. Conclusions: Deaths due to TBLc accounted for 8.73% of all cancer causalities in India in 2021.From 1990 to 2021, there was a notable increase in health metrics like incidence, mortality, and disability rates, particularly in Indian states like Uttarakhand, Gujarat, and Uttar Pradesh. Significant disparities were observed in the impact of aging on health, with the oldest populations facing the highest increases in mortality rates due to TBLc. Females showed higher annual percentage changes in these metrics compared to males. Projections for 2050 indicate a substantial rise in TBLc deaths, emphasizing the need for targeted public health interventions to address these regional and demographic disparities effectively.

The temporal trend in frailty prevalence from 2011 to 2020 and disparities by equity factors among middle-aged and older people in China: A population-based study.

Frailty is a challenging issue in China, however the prevalence of frailty across different population groups and whether this is changing over time remain unclear. Unstandardized and age-and sex-standardized prevalence of frailty (95 % confidence interval (95 % CI)) (Frailty Index) in the overall sample and for subgroups defined by equity factors (PROGRESS-Plus framework) from 2011 to 2020 were estimated using analyses of cross-sectional surveys in adults aged 45 and older participating in 5 waves (N = 16,784 to 18,904 across waves) of the China Health and Retirement Longitudinal Studies (CHARLS). Poisson regression was used to estimate prevalence ratios (PRs) of frailty by equity factors. Unstandardized prevalence of frailty increased from 13.6 % (13.0 %-14.1 %) in 2011 to 18.7 % (18.1 %-19.3 %) in 2020.The standardized prevalence increased from 13.5 % (13.0 %-14.0 %) in 2011 to 16.3 % (15.8 %-16.9 %) in 2020. Frailty was consistently more prevalent at advanced ages, in rural areas, among females, as well as those less educated, without social engagement, and non-drinkers. Based on the Poisson regression model, non-north region, being female and older, lower education, having no social engagement, smoking and non-drinking, and higher household capital consumption were associated with higher prevalence. The prevalence of frailty among the middle-aged and older population in China has increased. There will be an associated health and social care cost. Interventions targeted at older adults, those in rural areas, women, as well as those less educated, having no social engagement, and non-drinkers to mitigate the negative effects of frailty may be warranted.

Mortality trends from hepatocellular carcinoma associated with non-alcoholic fatty liver disease in the United States, 1999–2020: An analysis of the CDC WONDER database.

e16217 Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths, with non-alcoholic fatty liver disease (NAFLD) emerging as a significant risk factor. The rising prevalence of NAFLD, linked to obesity and metabolic syndrome, has led to its progression to HCC. This study analyzes trends in HCC mortality related to NAFLD from 1999 to 2020 to assess the disease burden and guide interventions. Methods: HCC deaths linked to NAFLD in adults aged 25 and older were retrieved from the CDC WONDER database (1999–2020) using ICD-10 codes liver cancer and NAFLD. Crude mortality rates (CMRs) and Age-adjusted mortality rates (AAMRs) per 100,000 were calculated by age, gender, region and race, with 95% confidence intervals (CI) for precision. Temporal trends and annual percentage changes (APCs) were analyzed using Joinpoint regression. Results: From 2005 to 2020, deaths increased by 1423%, from 23 to 277 annually, with total deaths reaching 1,446 and CMR rising from 0.001 to 0.083 per 100,000. Individuals aged 75-84 years had the highest CMR of 0.13 per 100,000 with an [APC: 23.26%; 95% CI: 18.61–31.40, p &lt; 0.01], followed by 65-74 years at 0.13 per 100,000 [APC: 5.56%; 95% CI: 12.69–20.28, p &lt; 0.0)] and 55-64 years at 0.04 [APC: 9.01%; 95% CI: 5.29–14.16, p &lt; 0.01]. Conversely, 85+ years group had a decline with CMR of 0.05 per 100,000 [APC: -6.33%; 95% CI: -6.33 to -6.33, p &lt; 0.01]. In the 45-54 years age group, the CMR was 0.02 per 100,000 [APC: 20%; 95% CI: 18.61–23.40, p &lt; 0.01]. 20% of total deaths of the 45-54 years group occured in 2020, highlighting a growing impact on younger populations linked to NAFLD-associated HCC. Males had a higher CMR (0.03, APC: 18.72%, p &lt; 0.01) compared to females (0.02, APC: 21.29%, p &lt; 0.01). For AAMR, males had a higher rate (0.0372, APC: 15.84%, p &lt; 0.01) than females (0.0216, APC: 19.87%, p &lt; 0.01). Geographically, CMRs were highest in the West (0.03, APC: 21.26%, p &lt; 0.01), followed by the South (0.02, APC: 22.86%, p &lt; 0.01), Midwest (0.02, APC: 15.00%, p &lt; 0.01), and Northeast (0.01, APC: 16.21%, p &lt; 0.01). AAMRs mirrored these trends, with the West again having the highest rate (0.0499, APC: 17.55%, p &lt; 0.01), followed by the Midwest (0.0378, APC: 19.30%, p &lt; 0.01), South (0.0300, APC: 20.02%, p &lt; 0.01), and Northeast (0.0285, APC: 56.99%, p &lt; 0.01). Racially, Whites had the highest CMR (0.03, APC: 19.87%, p &lt; 0.01), followed by American Indians/Alaska Natives, Asians/Pacific Islanders, and Black/African Americans. Conclusions: The sharp rise in mortality and tripling of deaths between 2016 and 2020, highlights a growing public health concern. Public health strategies should focus on equitable screening, early detection, and culturally tailored interventions to address systemic barriers. Expanding healthcare access, raising awareness, and incorporating social determinants are key to reducing the burden of HCC due to NAFLD.

Geographic, racial and temporal disparities in cancer and respiratory failure mortality in the US: A 24 year retrospective study.

e20520 Background: Cancer and respiratory failure (RF) are amongst leading causes of mortality in adults. This study investigates national trends in age-adjusted mortality rates (AAMRs) for cancer and RF in the United States from 1999 to 2023, focusing on disparities by gender, race, region, and rural-urban residence to inform public health strategies. Methods: This descriptive study analyzed data from the CDC WONDER database, of adults aged 25 and older. Mortality data were identified using ICD-10 codes C00–C97 (cancer) and J96 (RF). AAMRs per 100,000 population were calculated and stratified by gender, race/ethnicity, census region, urban-rural classification, and state. Temporal trends were analyzed using Joinpoint regression to estimate annual percent changes (APCs) with 95% confidence intervals (CIs). Statistical significance was set at p &lt; 0.05. Results: From 1999 to 2023, total deaths of 1,263,368 attributed to cancer and RF (682,141 men, 581,227 women). AAMRs declined from 1999 to 2004 (APC = -1.5, 95% CI: -4.0 to -0.4), stabilized from 2004 to 2012 (APC = 0.8, 95% CI: 0.1 to 2.4), and increased from 2012 to 2023 (APC = 3.2, 95% CI: 2.9 to 3.8). Men experienced a greater initial decline (APC = -2.1, 1999–2004) but significant increases thereafter (APC = 3.0, 2012–2023), while women showed a slower decline followed by sharper increases (APC = 3.5, 2013–2023). Non-Hispanic Black populations initially declined (APC = -1.7, 1999–2003) but later increased significantly (APC = 3.0, 2014–2020). Hispanic/Latino populations declined (APC = -1.2, 1999–2009) before rising sharply (APC = 3.1, 2009–2020). American Indian or Alaska Native populations showed consistent increases (APC = 1.7, 1999–2020). Urban areas experienced initial declines (APC = -1.7, 1999–2004), followed by increases (APC = 2.4, 2011–2020). Non-metropolitan areas exhibited steeper increases (APC = 4.6, 2014–2020). Regionally, the West recorded the highest AAMR (24.0), followed by the Northeast (23.6), South (20.9), and Midwest (18.0). Mississippi had the highest state-level AAMR (36.3), while Wisconsin had the lowest (10.0). States in the top 90th percentile included Mississippi, Arkansas, and California, while Wisconsin, Minnesota, and Oregon were among the lowest. Conclusions: Cancer and RF mortality declined initially but have significantly increased in recent years. Disparities persist across gender, racial, and regional groups, underscoring the need for focused public health efforts and equitable resource distribution to address these trends.

Incidence rates of liver and intrahepatic bile duct cancers in young Hispanic populations: An exploratory study of the SEER database, 2017-2021.

e22539 Background: Liver &amp; intrahepatic bile duct cancers rank 6th in U.S. cancer-related deaths. Prior studies have shown rising incidence of cancers in younger populations since the start of the century, with noted demographic disparities. We analyzed gender, age, and race/ethnicity-specific temporal trends from 2017-2021 to determine if similar trends are occurring in liver &amp; intrahepatic bile duct cancers. Methods: This exploratory analysis used Surveillance, Epidemiology, and End Results (SEER) program data to compare liver &amp; intraheptic bile duct cancer incidence rates from 2017-2021. These rates were further evaluated based on gender, age, and race/ethnicity. SEER*Stat software was utilized to compare incidence rates and average annual percentage change (AAPC). AAPC is a single measure that summarizes yearly percent change over a fixed period of time. Results: We initially analyzed incidence of liver &amp; intrahepatic bile duct cancers amongst all genders, races/ethnicities, and ages and compared this to younger populations aged 15-39. Amongst all age groups, the AAPC was 0.2% (CI - 0.1-0.8, p-value 0.15), compared to 0.7% (CI 0.0-0.8, p-value 0.05) in ages 15-39. We then further analyzed differences within the younger group, including gender, race, and ethnicity. Young Hispanic males aged 15-39 showed a significant AAPC increase of 2.5% (CI 2.0-3.2, p-value &lt; 0.01), while non-hispanic white males experienced a 0.9% decline (CI - 1.9- - 0.2, p-value 0.01). In non-Hispanic black males, the AAPC was 0.1% (CI - 0.1-0.3, p-value 0.18). Among Hispanic females aged 15-39, the AAPC increased significantly to 2.5% (CI 2.0-3.7, p-value &lt; 0.01), whereas decreases in non-Hispanic white and black females were non-significant at - 0.3% (CI - 1.4-0.4, p-value 0.25) and - 0.4% (CI - 2.1-0.6, p-value 0.40) respectively. Conclusions: Between 2017-2021, the incidence rates of liver &amp; intrahepatic bile duct cancers steadily increased amongst certain populations. This study specifically identified young Hispanic men and women aged 15-39 as a demographic group with a rising incidence for the development of these cancers. These findings highlight a prevention opportunity through improved screening methods. Recent trends in SEER Age-Adjusted incidence rates, 2017-2021. Group Average Annual Percent Change (AAPC) Lower 95% C.l. Upper 95% C.I. P-Value Males &amp; Females, All Races/Ethnicities, All Ages 0.2% -0.1 0.8 0.15 Males &amp; Females, All Races/Ethnicities, Ages 15-39 0.7% 0.0 0.8 0.05 Males, Non-Hispanic White, Ages 15-39 -0.9% -1.9 -0.2 0.01 Females, Non-Hispanic White, Ages 15-39 -0.3% -1.4 0.4 0.25 Males, Non-Hispanic Black, Ages 15-39 0.1% -0.1 0.3 0.18 Females, Non-Hispanic Black, Ages 15-39 -0.4% -2.1 0.6 0.40 Males, Hispanic (any race), Ages 15-39 2.5% 2.0 3.2 &lt;0.01 Females, Hispanic (any race), Ages 15-39 2.5% 2.0 3.7 &lt;0.01

Characteristics of Streptococcus pyogenes causing invasive infections among adults in Portugal, 2016-2019: Pre-COVID-19 expansion of the M1UK sublineage.

Characteristics of Streptococcus pyogenes causing invasive infections among adults in Portugal, 2016-2019: Pre-COVID-19 expansion of the M1UK sublineage.

A real-world data claims-based review of CAR-T procedures, time to adverse events, patient characteristics and social factors.

11163 Background: With the increasing utilization of Chimeric antigen receptors T-cell therapies (CAR-T), administrative claims can provide insights into approved CAR-T therapies, procedures, associated adverse events (AEs) and population characteristics. Methods: We used administrative open claims with medical and pharmacy encounters of 330 million US patients (PurpleLab). We identified patients with a coded AE as the principial diagnosis following the first initial claim with any CAR-T. CAR-T claims were identified with drug and procedure coding. The AEs included were Cytokine release syndrome (CRS), Immune effector-cell associated neurotoxicity (ICANS), complication of immune effector cellular therapy, tumor lysis, and cardiovascular events such as arrhythmias. The time to the AE and death were noted. In cases where social determinants of health (SDOH) are noted, race, gender, marital status, occupation, and education were analyzed. Results: The number of patients with CAR-T related claims within the database was 20,003. Of those patients, approximately 10% (2166) had at least one claim with an AE code as the principal diagnosis reported following the very first CAR-T claim. For those with an initial AE claim, 38% had a cardiovascular event, 36% had a complication of immune effector cellular therapy, 13% had a CRS event, 7% had an ICANS, 2% had a tumor lysis event, and 1.3% had a secondary lymphoma. Most AEs occurred within the first 30 to 90 days from the first documented CAR-T claim procedure. Cardiac and complication AEs were higher in patients aged greater than 65, while tumor lysis was higher in patients under 65. Death was reported in a quarter of the patients (532 patients) with 65% of those recorded deaths occurring within a year post first CAR-T related claim. Of those patients with a documented social demographic factor, patients with AEs were white males (41%), Asian males (2.6%), African American males (2.7%), and unspecified males (17%) making up the other races and gender. In terms of occupation and education, 34% were white collar, 5% blue collar, and 4% retired, and 29% had some level of high school, 23% college-level education, and 13% were postgraduate. More patients were identified as married (34%) than single (14%) and approximately 57% had an income below $100,000, while 11% were above $100,000, with the remaining incomes were not recorded. Conclusions: Real-world data can provide insights into CAR-T and AEs, patient social factors, and temporal trends. Age greater than 65 seemed the more prevalent SDOH with higher AE seen in this subgroup. Additional investigation on AEs within the different patient population subgroups are needed to provide deeper insights into treatment effects.

Spatio-temporal pattern and risk factors of HIV/AIDS prevalence in Zhejiang, China, from 2005 to 2022 using R-INLA.

Spatio-temporal pattern and risk factors of HIV/AIDS prevalence in Zhejiang, China, from 2005 to 2022 using R-INLA.

Temporal trends in the incidence of Hodgkin's lymphoma in the Middle East and North Africa over the past three decades.

e19041 Background: Hodgkin lymphoma (HL) is a rare yet important hematologic malignancy of B-cell origin. While global incidence rates vary, the epidemiology of HL in the Middle East and North Africa (MENA) is not well understood due to limited regional data. This study uses Global Burden of Disease (GBD) data to analyze HL incidence trends in MENA over the past three decades, aiming to shed light on the evolving burden of the disease in this region. Methods: Data on age-standardized incidence rates (ASIR) for HL in the MENA from 1990 to 2019 were collected from the GBD database. Joinpoint regression software was utilized to calculate the annual percent change (APC) and average annual percent change (AAPC) in ASIR, with stratification by country. Results: From 1990 to 2019, an estimated total of 94,221 cases of HL were reported in the MENA, with 58.2% of cases in males. A statistically significant increase in ASIR was observed across the region, with an AAPC of 0.40 (95% CI 0.37 to 0.43, p&lt;0.001). Significant increases in ASIR were observed in Algeria, Bahrain, Iran, Jordan, Libya, Oman, Qatar, Saudi Arabia, Syria, and Tunisia, with the most prominent rise in Iran (AAPC 2.84). In contrast, Afghanistan, Iraq, Morocco, Palestinian Territories, Sudan, Turkey, and Yemen experienced significant declines in ASIR, with the steepest decrease seen in Morocco (AAPC -0.27). No significant changes were observed in Egypt and the United Arab Emirates. Conclusions: Our analysis shows a significant increase in HL incidence across the MENA from 1990 to 2019. The rise was especially noted in Iran, Saudi Arabia, and Tunisia. This increase could reflect improved early detection, better reporting systems, and changes in environmental or lifestyle factors. However, Morocco, Yemen, and Iraq saw declines, while Egypt and the UAE showed no significant changes. The varying trends reflect the complex, often bimodal patterns seen globally, likely driven by a combination of better healthcare access, epidemiological shifts, and environmental influences. These findings emphasize the need for region-specific healthcare strategies to address the growing HL burden in the MENA.

Spatial-temporal analysis of cervical cancer screening and social and health indicators in Brazil.

Spatial-temporal analysis of cervical cancer screening and social and health indicators in Brazil.