scholarly journals All‐cause mortality versus cancer‐specific mortality as outcome in cancer screening trials: A review and modeling study

2019 ◽  
Vol 8 (13) ◽  
pp. 6127-6138 ◽  
Author(s):  
Eveline A. M. Heijnsdijk ◽  
Marcell Csanádi ◽  
Andrea Gini ◽  
Kevin Haaf ◽  
Rita Bendes ◽  
...  
Keyword(s):  
Cancer Screening ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Modeling Study ◽  
Screening Trials

scholarly journals Effects of cancer screening restart strategies after COVID-19 disruption

2021 ◽  
Vol 124 (9) ◽  
pp. 1516-1523
Author(s):  
Lindy M. Kregting ◽  
Sylvia Kaljouw ◽  
Lucie de Jonge ◽  
Erik E. L. Jansen ◽  
Elleke F. P. Peterse ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Catching Up ◽  
Incidence And Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Catch Up ◽  
Microsimulation Models ◽  
The Impact

Abstract Background Many breast, cervical, and colorectal cancer screening programmes were disrupted due to the COVID-19 pandemic. This study aimed to estimate the effects of five restart strategies after the disruption on required screening capacity and cancer burden. Methods Microsimulation models simulated five restart strategies for breast, cervical, and colorectal cancer screening. The models estimated required screening capacity, cancer incidence, and cancer-specific mortality after a disruption of 6 months. The restart strategies varied in whether screens were caught up or not and, if so, immediately or delayed, and whether the upper age limit was increased. Results The disruption in screening programmes without catch-up of missed screens led to an increase of 2.0, 0.3, and 2.5 cancer deaths per 100 000 individuals in 10 years in breast, cervical, and colorectal cancer, respectively. Immediately catching-up missed screens minimised the impact of the disruption but required a surge in screening capacity. Delaying screening, but still offering all screening rounds gave the best balance between required capacity, incidence, and mortality. Conclusions Strategies with the smallest loss in health effects were also the most burdensome for the screening organisations. Which strategy is preferred depends on the organisation and available capacity in a country.

scholarly journals Hormone replacement therapy in women with cancer and risk of cancer-specific mortality and cardiovascular disease: a protocol for a cohort study from Scotland and Wales

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Úna McMenamin ◽  
Blánaid Hicks ◽  
Carmel Hughes ◽  
Peter Murchie ◽  
Julia Hippisley-Cox ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Hormone Replacement Therapy ◽  
Venous Thromboembolism ◽  
Replacement Therapy ◽  
Cancer Diagnosis ◽  
Hormone Replacement ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Risk Of Cancer

Abstract Background Hormone replacement therapy (HRT) is widely used and has proven benefits for women with menopausal symptoms. An increasing number of women with cancer experience menopausal symptoms but the safety of HRT use in women with cancer is unclear. There are particular concerns that HRT could accelerate cancer progression in women with cancer, and also that HRT could increase the risk of cardiovascular disease in such women. Therefore, our primary aim is to determine whether HRT use alters the risk of cancer-specific mortality in women with a range of common cancers. Our secondary objectives are to investigate whether HRT alters the risk of second cancers, cardiovascular disease, venous thromboembolism and all-cause mortality. Methods The study will utilise independent population-based data from Wales using the SAIL databank and Scotland based upon the national Prescribing Information System. The study will include women newly diagnosed with common cancers from 2000 to 2016, identified from cancer registries. Women with breast cancers will be excluded. HRT will be ascertained using electronic prescribing in Wales or dispensing records in Scotland. The primary outcome will be time to cancer-specific mortality from national mortality records. Time-dependent cox regression models will be used to calculate hazard ratios (HR) and 95% confidence intervals (95% CIs) for cancer specific death in HRT users compared with non-users after cancer diagnosis after adjusting for relevant confounders, stratified by cancer site. Analysis will be repeated investigating the impact of HRT use immediately before cancer diagnosis. Secondary analyses will be conducted on the risk of second cancers, cardiovascular disease, venous thromboembolism and all-cause mortality. Analyses will be conducted within each cohort and pooled across cohorts. Discussion Our study will provide evidence to inform guidance given to women diagnosed with cancer on the safety of HRT use and/or guide modifications to clinical practice.

scholarly journals Mediating-Moderating Effect of Allostatic Load on the Association between Dietary Approaches to Stop Hypertension Diet and All-Cause and Cause-Specific Mortality: 2001–2010 National Health and Nutrition Examination Surveys

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2311 ◽  
Author(s):  
Hind A. Beydoun ◽  
Shuyan Huang ◽  
May A. Beydoun ◽  
Sharmin Hossain ◽  
Alan B. Zonderman
Keyword(s):  
Cardiovascular Disease ◽  
Allostatic Load ◽  
Moderating Effects ◽  
Dash Diet ◽  
Health And Nutrition ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Cancer Specific Mortality ◽  
Disease Specific

This secondary analysis of survey data examined mediating-moderating effects of allostatic load score (calculated using the Rodriquez method) on the association between nutrient-based Dietary Approaches to Stop Hypertension (DASH) diet score (Mellen Index) and the all-cause and cause-specific mortality risks among 11,630 adults ≥ 30 years of age from the 2001–2010 National Health and Nutrition Examination Surveys with no history of cardiovascular disease or cancer at baseline, and who were followed-up for ~9.35 years. Multivariable models were adjusted for demographic, socioeconomic, lifestyle, and health characteristics. All-cause, cardiovascular disease, and cancer-specific mortality rates were estimated at 6.5%, 1.1%, and 1.9%, respectively. The median DASH total score was 3.0 (range: 1–8) (with 78.3% scoring < 4.5), whereas the median allostatic load score was 3 (range: 0–9). The DASH diet, fiber, and magnesium were negatively correlated with allostatic load, whereas allostatic load predicted higher all-cause mortality, irrespective of the DASH diet. Whereas protein was protective, potassium increased all-cause mortality risk, irrespective of allostatic load. Potassium was protective against cardiovascular disease-specific mortality but was a risk factor for cancer-specific mortality. Although no moderating effects were observed, mediation by the allostatic load on cardiovascular disease-specific mortality was observed for DASH total score and selected component scores. Direct (but not indirect) effects of DASH through the allostatic load were observed for all-cause mortality, and no direct or indirect effects were observed for cancer-specific mortality. From a public health standpoint, the allostatic load may be a surrogate for the preventive effects of the DASH diet and its components on cardiovascular disease-specific mortality risk.

The relationship between statins and breast cancer prognosis varies by statin type and exposure time: A meta-analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21606-e21606
Author(s):  
Binliang Liu ◽  
Zongbi Yi ◽  
Xiuwen Guan ◽  
Fei Ma ◽  
Yi-Xin Zeng
Keyword(s):  
Breast Cancer ◽  
Protective Effect ◽  
Breast Cancer Prognosis ◽  
Cancer Prognosis ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
The Relationship ◽  
Statin Use

e21606 Background:Breast cancer is the most common cancer in females. The effects of statins on breast cancer prognosis have long been controversial, so it is important to investigate the relationship between statin type, exposure time, and breast cancer prognosis. This study sought to explore the effect of statins on breast cancer prognosis. Methods:We searched the MEDLINE, EMBASE, Cochrane Library between October 15, 2016 and January 20, 2017. Searches combined the terms “breast neoplasms[MeSH]”, “statins”, “prognosis” or “survival” or “mortality” with no limit on publication date. Data were analyzed using Stata/SE 11.0. Results: 7 studies finally met the selection criteria and 197,048 included women. Overall statin use was associated with lower cancer-specific mortality and all-cause mortality (HR 0.73, 95% CI 0.59-0.92, P = 0.000 and HR 0.72, 95% CI 0.58-0.89, P = 0.000). Lipophilic statins were associated with decreased breast cancer-specific and all-cause mortality (HR 0.57, 95% CI 0.46-0.70, P = 0.000 and HR 0.57, 95% CI 0.48-0.69, P = 0.000); however, hydrophilic statins were weakly protective against only all-cause mortality (HR 0.79, 95% CI 0.65-0.97, P = 0.132) and not breast cancer-specific mortality (HR 0.94, 95% CI 0.76-1.17, P = 0.174). Of note, more than four years of follow-up did not show a significant correlation between statin use and cancer-specific mortality or all-cause mortality (HR 0.84, 95% CI 0.71-1.00, P = 0.616 and HR 0.95, 95% CI 0.75-1.19, P = 0.181), while groups with less than four years of follow-up still showed the protective effect of statins against cancer-specific mortality and all-cause mortality (HR 0.62, 95% CI 0.44-0.87, P = 0.000 and HR 0.61, 95% CI 0.45-0.80, P = 0.000). Conclusions:Although statins can reduce breast cancer patient mortality, the benefit appears to be constrained by statin type and follow-up time. Lipophilic statins showed a strong protective function in breast cancer patients, while hydrophilic statins only slightly improved all-cause mortality. Finally, the protective effect of statins could only be observed in groups with less than four years of follow-up.

scholarly journals Multidimensional Machine Learning Personalized Prognostic Model in an Early Invasive Breast Cancer Population-Based Cohort in China: Algorithm Validation Study (Preprint)

2020 ◽  
Author(s):  
Xiaorong Zhong ◽  
Ting Luo ◽  
Ling Deng ◽  
Pei Liu ◽  
Kejia Hu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Progression ◽  
Invasive Breast Cancer ◽  
Prognostic Model ◽  
The United States ◽  
Biomedical Ethics ◽  
Extreme Gradient Boosting ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality

BACKGROUND Current online prognostic prediction models for breast cancer, such as Adjuvant! Online and PREDICT, are based on specific populations. They have been well validated and widely used in the United States and Western Europe; however, several validation attempts in non-European countries have revealed suboptimal predictions. OBJECTIVE We aimed to develop an advanced breast cancer prognosis model for disease progression, cancer-specific mortality, and all-cause mortality by integrating tumor, demographic, and treatment characteristics from a large breast cancer cohort in China. METHODS This study was approved by the Clinical Test and Biomedical Ethics Committee of West China Hospital, Sichuan University on May 17, 2012. Data collection for this project was started in May 2017 and ended in March 2019. Data on 5293 women diagnosed with stage I to III invasive breast cancer between 2000 and 2013 were collected. Disease progression, cancer-specific mortality, all-cause mortality, and the likelihood of disease progression or death within a 5-year period were predicted. Extreme gradient boosting was used to develop the prediction model. Model performance was assessed by calculating the area under the receiver operating characteristic curve (AUROC), and the model was calibrated and compared with PREDICT. RESULTS The training, test, and validation sets comprised 3276 (499 progressions, 202 breast cancer-specific deaths, and 261 all-cause deaths within 5-year follow-up), 1405 (211 progressions, 94 breast cancer-specific deaths, and 129 all-cause deaths), and 612 (109 progressions, 33 breast cancer-specific deaths, and 37 all-cause deaths) women, respectively. The AUROC values for disease progression, cancer-specific mortality, and all-cause mortality were 0.76, 0.88, and 0.82 for training set; 0.79, 0.80, and 0.83 for the test set; and 0.79, 0.84, and 0.88 for the validation set, respectively. Calibration analysis demonstrated good agreement between predicted and observed events within 5 years. Comparable AUROC and calibration results were confirmed in different age, residence status, and receptor status subgroups. Compared with PREDICT, our model showed similar AUROC and improved calibration values. CONCLUSIONS Our prognostic model exhibits high discrimination and good calibration. It may facilitate prognosis prediction and clinical decision making for patients with breast cancer in China.

Mediastinal lymph node examination and survival in resected early-stage non-small cell lung cancer in the Surveillance, Epidemiology, and End Results (SEER) database.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7069-7069
Author(s):  
Raymond U Osarogiagbon ◽  
Xinhua Yu
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Mediastinal Lymph Node ◽  
Small Cell ◽  
Small Cell Lung ◽  
Term Survival ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality

7069 Background: Pathologic nodal stage is a key prognostic factor in resectable non-small cell lung cancer (NSCLC). Mediastinal lymph node (MLN) metastasis connotes a poor prognosis. Yet, some NSCLC resections in the US do not include MLN examination. Methods: We analyzed SEER data from 1998 to 2002 to quantify the long-term survival impact of failure to examine MLN in resected NSCLC. We used Kaplan-Meier methods to compare the unadjusted survival difference between patients with, and without, MLN examination. We used Cox proportional hazards and competing risk models to serially adjust for the impact of risk factors on survival differences. Results: Sixty-two percent of patients with pathologic N0 or N1 NSCLC had no MLN examined. Men, African-Americans, patients with more advanced stage, and those who had less than pneumonectomy were less likely to have MLN examination. Five-year all-cause mortality (46.9% v 51.7%, p<.001), and lung cancer-specific mortality (31.5% v 36%, p<.001), rates were higher in those without MLN examination. After adjustment for potential confounders, MLN examination was associated with a 6% reduction in all-cause mortality (HR, 0.94; CI, 0.89-0.99; p=.014), and 10% reduction in lung cancer-specific mortality (HR, 0.90; 95% CI, 0.84-0.96; p=.002) rates. The excess risk in 1 year’s cohort of U.S. lung resections was 2,700 lives over 5 years. Conclusions: Failure to examine MLN was a common practice in "MLN-negative" NSCLC resections, which significantly impaired long-term survival. Efforts to understand the etiology of this quality gap, and measures to eliminate it, are warranted.

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