Geographical clustering of anal cancer incidence in Australia

Introduction: Homosexual men are at an increased risk of anal cancer. We aimed to establish the burden of anal squamous cell carcinoma (SCC) in those parts of Australia where homosexual men are most likely to live. Methods: Data on the proportion of homosexual male residents were obtained from published estimates. Men were categorised into three postcode groups by prevalence of men reporting homosexual identity. Male population data in age groups were extracted for each postcode group and analyses of cancer incidence were performed by postcode group. The analyses were restricted to 2000–2005. Results: Eight postcodes had populations where more than 10% of males reported homosexual identity (high prevalence) and 4–10% of men reported homosexual activity in a further 19 postcodes (medium prevalence). From 2000 to 2005, the average annual age-standardised incidence rates of anal SCC in males was 7.61 per 100 000 (95% confidence interval (CI): 4.68–10.55) and 2.21 per 100 000 (95% CI: 1.05–3.37) in high and medium prevalence postcodes, respectively. The corresponding incidence rate ratios compared with low prevalence postcodes (less than 4% of males reported homosexual identity) were 9.6 (95% CI: 6.6–14.1) for the high prevalence and 2.4 (95% CI: 1.4–4.1) for the medium prevalence postcodes. Conclusion: A substantial concentration of the burden of anal cancer occurred among areas where large proportions of homosexual men reside. These results should guide the prioritisation of health service investment in anal cancer treatment and prevention to appropriate geographical areas.

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Vroegtijdige opsporing van voorstadia van een anaal carcinoom bij hiv-seropositieve patiënten

Tijdschrift voor Geneeskunde ◽

10.47671/tvg.77.21.129 ◽

2021 ◽

Author(s):

E. GÖKCE ◽

J. GELDOF ◽

P. ROELANDT ◽

J. VAN DORPE ◽

S. CALLENS ◽

...

Keyword(s):

Anal Cancer ◽

Digital Rectal Examination ◽

Intraepithelial Neoplasia ◽

Hpv Infection ◽

High Grade ◽

Anal Squamous Cell Carcinoma ◽

Increased Risk ◽

High Prevalence ◽

Risk Patients ◽

Hiv Seropositive

Early detection of precursor lesions of anal cancer in HIV-seropositive patients Although anal cancer is rare in the overall population, its incidence is increasing in the last decades. Especially HIV-seropositive patients have an increased risk of developing anal squamous cell carcinoma (SCC), mainly because of the high prevalence of high-grade anal intraepithelial neoplasia (AIN) among these patients. High-grade AIN is a precursor lesion for anal SCC associated with human papillomavirus (HPV) infection. Despite the lack of direct evidence demonstrating that AIN identification reduces the risk of anal cancer, experts think that screening and treatment of high-risk patients will prevent the disease. This article aims to review the current literature about AIN and discusses the screening options, including digital rectal examination, anal cytology and high-resolution anoscopy.

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Colorectal Cancer in Young and Older Adults in Uruguay: Changes in Recent Incidence and Mortality Trends

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158232 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8232

Author(s):

Carina Musetti ◽

Mariela Garau ◽

Rafael Alonso ◽

Marion Piñeros ◽

Isabelle Soerjomataram ◽

...

Keyword(s):

Colorectal Cancer ◽

Older Adults ◽

Cancer Incidence ◽

Age Groups ◽

Incidence Rates ◽

Mortality Trends ◽

Screening Programs ◽

Lifestyle Risk Factors ◽

Incidence And Mortality ◽

Colorectal Cancer Incidence

Uruguay has the highest colorectal cancer incidence rates in Latin America. Previous studies reported a stable incidence and a slight increase in mortality among males. We aimed to assess colorectal cancer incidence (2002–2017) and mortality trends (1990–2017) by age groups and sex, using data from the National Cancer Registry. Annual percent changes (APCs) were estimated using joinpoint regression models. We included 27,561 colorectal cancer cases and 25,403 deaths. We found an increasing incidence among both males and females aged 40–49, with annual increases of 3.1% (95%CI: 1.21–5.03) and 2.1% (95%CI: 0.49–3.66), respectively, and an increasein the rate in older males (70+) of 0.60% (95%CI: 0.02–1.20) per year between 2002 and 2017. Mortality remained stable among those younger than 50, whereas it decreased for older females aged 50–69 and 70+ (APC: −0.61% (−1.07–0.14) and −0.68% (−1.02–0.34), respectively), and increased for the oldest males (70+; APC: 0.74 (0.47–1.01)). In conclusion, we found rising colorectal cancer incidence accompanied by stable mortality in young adults. Sex disparities were also found among the older adults, with a more favorable pattern for females. Exposures to dietary and lifestyle risk factors, and inequalities in access to and awareness of screening programs, are probably among the main underlying causes and deserve further investigation.

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Marked Increase in Incident Gynecomastia: A 20-Year National Registry Study, 1998 to 2017

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa440 ◽

2020 ◽

Vol 105 (10) ◽

pp. 3134-3140 ◽

Cited By ~ 1

Author(s):

Trine Koch ◽

Elvira V Bräuner ◽

Alexander S Busch ◽

Martha Hickey ◽

Anders Juul

Keyword(s):

Age Groups ◽

Population Based ◽

Incidence Rates ◽

National Registry ◽

Registry Study ◽

Age Related ◽

Danish Health ◽

Increased Risk ◽

National Patient ◽

First Time

Abstract Context Gynecomastia, the proliferation of mammary glandular tissue in the male, is a frequent but little-studied condition. Available prevalence data are based on selected patient populations or autopsy cases with their inherent bias. Objective The objective of this work is to evaluate the age-related incidence and secular trends in gynecomastia in the general population. Design An observational, 20-year national registry study was conducted. Setting This population-based study used nationwide registry data. Participants Participants included all Danish males (age 0-80 years) with a first-time diagnosis of gynecomastia. Main Outcome Measures All Danish males (age 0-80 years) were followed up for incident diagnosis of gynecomastia in the Danish National Patient Registry from 1998 to 2017 using the International Codes of Diseases, 10th revision, and the Danish Health Care Classification System. Age-specific incidence rates were estimated. The hypothesis tested in this study was formulated prior to data collection. Results Overall, a total 17 601 males (age 0-80 years) were registered with an incident diagnosis of gynecomastia within the 20-year study period, corresponding to 880 new cases per year and an average 20-year incidence of 3.4 per 10 000 men (age 0-80 years). The average annual incidence was 6.5/10 000 in postpubertal males age 16 to 20 years and 4.6/10 000 in males age 61 to 80 years, with a respective 5- and 11-fold overall increase in these 2 age groups over the 20-year period. Conclusions The incidence of gynecomastia has dramatically increased over the last 20 years, implying that the endogenous or exogenous sex-steroid environment has changed, which is associated with other adverse health consequences in men such as an increased risk of prostate cancer, metabolic syndrome, type 2 diabetes, or cardiovascular disorders.

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Investigating epidemiologic trends and the geographic distribution of patients with anal squamous cell carcinoma throughout Canada

Current Oncology ◽

10.3747/co.27.6061 ◽

2020 ◽

Vol 27 (3) ◽

Author(s):

L. Cattelan ◽

F. M. Ghazawi ◽

M. Le ◽

E. Savin ◽

A. Zubarev ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Anal Cancer ◽

Squamous Cell ◽

Demographic Data ◽

Cancer Registries ◽

The United States ◽

Incidence Rates ◽

Anal Squamous Cell Carcinoma ◽

Incidence And Mortality

Background Anal cancer is a rare disease, constituting 0.5% of new cancer cases in the United States. The most common subtype is squamous cell carcinoma (scc). Studies in several developed nations have reported on an increasing incidence of anal cancer in recent decades, and various risk factors pertaining to the pathogenesis of the disease have been identified, including infection with the human papillomavirus, tobacco use, and immunosuppression. The epidemiology and distribution of anal scc throughout Canada remain poorly understood, however. Methods Using 3 population-based cancer registries, a retrospective analysis of demographic data across Canada for 1992–2010 was performed. The incidence and mortality for anal scc was examined at the levels of provinces, cities, and the forward sortation area (FSA) component (first 3 characters) of postal codes. Results During 1992–2010, 3720 individuals were diagnosed with anal scc in Canada; 64% were women. The overall national incidence rate was 6.3 cases per million population per year, with an average age at diagnosis of 60.4 years. The incidence increased over time, with significantly higher incidence rates documented in British Columbia and Nova Scotia (9.3 cases per million population each). Closer examination revealed clustering of cases in various urban centres and self-identified lgbtq communities in Toronto, Montreal, and Vancouver. Discussion This study provides, for the first time, a comprehensive analysis of the burden of anal scc in Canada, identifying susceptible populations and shedding light onto novel avenues of research to lower the incidence of anal cancer throughout the country.

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Cancer Incidence in Patients With Acromegaly: A Cohort Study and Meta-Analysis of the Literature

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2017-02457 ◽

2018 ◽

Vol 103 (6) ◽

pp. 2182-2188 ◽

Cited By ~ 38

Author(s):

Jakob Dal ◽

Michelle Z Leisner ◽

Kasper Hermansen ◽

Dóra Körmendiné Farkas ◽

Mads Bengtsen ◽

...

Keyword(s):

Breast Cancer ◽

Colorectal Cancer ◽

Cohort Study ◽

Cancer Incidence ◽

Meta Analysis ◽

Population Based ◽

Incidence Rates ◽

Tract Cancer ◽

Increased Risk ◽

Risk Of Cancer

Abstract Context Acromegaly has been associated with increased risk of cancer morbidity and mortality, but research findings remain conflicting and population-based data are scarce. We therefore examined whether patients with acromegaly are at higher risk of cancer. Design A nationwide cohort study (1978 to 2010) including 529 acromegaly cases was performed. Incident cancer diagnoses and mortality were compared with national rates estimating standardized incidence ratios (SIRs). A meta-analysis of cancer SIRs from 23 studies (including the present one) was performed. Results The cohort study identified 81 cases of cancer after exclusion of cases diagnosed within the first year [SIR 1.1; 95% confidence interval (CI), 0.9 to 1.4]. SIRs were 1.4 (95% CI, 0.7 to 2.6) for colorectal cancer, 1.1 (95% CI, 0.5 to 2.1) for breast cancer, and 1.4 (95% CI, 0.6 to 2.6) for prostate cancer. Whereas overall mortality was elevated in acromegaly (SIR 1.3; 95% CI, 1.1 to 1.6), cancer-specific mortality was not. The meta-analysis yielded an SIR of overall cancer of 1.5 (95% CI, 1.2 to 1.8). SIRs were elevated for colorectal cancer, 2.6 (95% CI, 1.7 to 4.0); thyroid cancer, 9.2 (95% CI, 4.2 to 19.9); breast cancer, 1.6 (1.1 to 2.3); gastric cancer, 2.0 (95% CI, 1.4 to 2.9); and urinary tract cancer, 1.5 (95% CI, 1.0 to 2.3). In general, cancer SIR was higher in single-center studies and in studies with <10 cancer cases. Conclusions Cancer incidence rates were slightly elevated in patients with acromegaly in our study, and this finding was supported by the meta-analysis of 23 studies, although it also suggested the presence of selection bias in some earlier studies.

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SPATIAL ANALYSIS OF CERVICAL CANCER INCIDENCE IN IRAQ DURING 2010-2015

Malaysian Journal of Public Health Medicine ◽

10.37268/mjphm/vol.21/no.3/art.1097 ◽

2021 ◽

Vol 21 (3) ◽

pp. 209-216

Author(s):

Muzahem Al-Hashimi ◽

Safwan Nathem Rashed

Keyword(s):

Cervical Cancer ◽

High Risk ◽

Cancer Incidence ◽

Spatial Clustering ◽

Age Groups ◽

Health Resources ◽

Incidence Rates ◽

Cervical Cancer Incidence ◽

Spatial Statistical Analysis ◽

Adjusted Incidence

Cervical cancer is the most common cancer in Iraq. This study aimed to examine the spatial pattern and high-risk clusters of cervical cancer in different areas of Iraq (except the Kurdish region) during the period 2010-2015. The age-adjusted incidence rates (AAIRs), age-specific incidence rates (ASIRs), and annual percent changes (APCs) were calculated for 2010–2015. We used three techniques of spatial statistical analysis which are Global spatial autocorrelation, Getis-Ord Gi* statistic, and Anselin Local Moran’s statistic to investigate spatial clustering and outliers. Over the period 2000-2015, 1037 cases were diagnosed with AAIR of incidence of (3.521 per 100,000). Depending on AAIRs, we found cervical cancer incidence was highest (8.212 per 100,000) in the age group of 60-69 years old. The APC of cervical cancer age-specific rates has significantly risen for the age groups 60-69 only. We identified spatial high-risk clusters for incidence. The cluster was mainly located in the center of Iraq (Baghdad, Najaf, Kerbala, and Babil provinces), the central-eastern part of Iraq (Diyala province), and the southern part of Iraq (Basrah province). While the provinces in the northern and northeastern parts of Iraq, as well as the western province, had relatively lower AAIRs from cervical cancer. A spatial cluster pattern for the incidence of cervical cancer in Iraq was revealed, which will be valuable for improving the allocation of health resources in Iraq.

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33. Gradually decreasing anal cancer incidence in the HIV+ population in the Netherlands after a decade of cART

Sexual Health ◽

10.1071/shv10n6ab33 ◽

2013 ◽

Vol 10 (6) ◽

pp. 586

Author(s):

O. Richel ◽

R. P. Van der Zee ◽

C. Smit ◽

H. J. C. De Vries ◽

J. M. Prins

Keyword(s):

Risk Factors ◽

Alcohol Abuse ◽

Anal Cancer ◽

Cancer Incidence ◽

Potential Risk ◽

Incidence Rates ◽

Hiv Patients ◽

Hazard Ratios ◽

Potential Risk Factors ◽

Sex With Men

Background Anal cancer incidence has been increasing in the combined antiretroviral therapy (cART) era in HIV+ patients. In this study we surveyed trends in anal cancer incidence between 1995 and 2012, and analysed a range of potential risk factors. Methods: We retrieved data for all patients diagnosed with anal cancer from the Dutch HIV observational cohort (ATHENA) database. Incidence rates were calculated per 100 000 person-years of follow-up (FU), for the whole period of 18 years, and per 2-year blocks. Potential risk factors were analysed in a uni- and multivariable Cox proportional hazard model. Results: For all HIV+ patients, men who have sex with men (MSM), and heterosexual men and women, respectively, the incidence of anal cancer was 83 (95% CI 70–99), 116 (95% CI 95–140), 44 (95% CI 21–83) and 12 (95% 3–30) per 100 000 person-years of FU. In 2005–2006, a peak in incidence rates was observed of 114 (95% CI 74–169) in the total HIV population and 168 (95% CI 103–259) among HIV+ MSM, followed by a decrease to 72 (95% CI 42–113) and 100 (95% CI 56–164), respectively, in 2011–2012. Low nadir CD4 (<110), alcohol abuse and smoking were significantly associated with anal cancer in MSM, with hazard ratios (HR) of 2.41 (95%CI 1.5–3.89), 2.23 (95% CI 1.28–3.89) and 1.60 (95% CI 1.07–2.41), respectively. Conclusions: Anal cancer remains a serious problem in predominantly HIV+ MSM; however, it seems that incidence rates are levelling off. A low nadir CD4 count, alcohol abuse and smoking are risk factors for the development of anal cancer.

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Racial/ethnic variation in incidence rates for anal cancer in New Mexico.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.601 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 601-601

Author(s):

Diaa Osman ◽

Bridget N. Fahy ◽

Jessica Belmonte ◽

Angela W. Meisner ◽

Charles Wiggins

Keyword(s):

New Mexico ◽

Ethnic Groups ◽

American Indians ◽

Anal Cancer ◽

Cancer Incidence ◽

Incidence Rates ◽

Core Areas ◽

Race Ethnicity ◽

Racial Ethnic ◽

Cancer Incidence Rates

601 Background: Anal cancer comprises only 2.5% of all digestive system malignancies in the United States; only 8200 new cases are diagnosed annually, nevertheless, an increasing incidence rate has been noted. The goal of this study is to describe the incidence rates of anal cancer in New Mexico. New Mexico is a unique, mainly rural state, with unique demographics consisting of a large mix of patients being primarily Non-Hispanic White, Hispanics or Native Americans. Methods: All incident cases of anal cancer diagnosed among New Mexico residents during the twenty-year period 1995-2014 were identified from the population-based New Mexico Tumor Registry. Average annual age-adjusted incidence rates (US 2000 standard) were calculated by the direct method for non-Hispanic whites, Hispanics and American Indians. Incidence rates for non-Hispanic whites in nine core areas of the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program served as the comparison. Results: A total of 556 anal cancers were diagnosed among New Mexico residents during the study period, an average of approximate 28 cancers annually. Anal cancer incidence rates per 100,000 were highest for non-Hispanic whites (1.80, 95% Confidence Interval (CI) 1.62-1.98) in New Mexico, which were similar to rates for non-Hispanic whites (1.70, 95% CI 1.66-1.74) in nine core areas of the SEER Program. Statistically significant lower rates were observed in New Mexico Hispanics (0.92, 95% CI 0.76-1.11) and American Indians (0.75, 95% CI 0.45-1.16). Females had higher rates than males in each of these three racial/ethnic groups. Incidence rates increased from 1995-2004 to 2005-2014 for all race/ethnic groups, with the largest increase observed in Hispanic females. Conclusions: Anal cancer incidence rates vary by race/ethnicity and sex in New Mexico. Further research is needed to characterize time trends in incidence and to identify factors that may account for observed differences in incidence rates by race/ethnicity and sex in New Mexico.

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Chemoradiation-related lymphopenia and its association with survival in patients with anal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.3 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 3-3

Author(s):

Grace Lee ◽

Daniel W. Kim ◽

Vinayak Muralidhar ◽

Devarati Mitra ◽

Nora Horick ◽

...

Keyword(s):

Cancer Patients ◽

Anal Cancer ◽

Cox Regression ◽

Cox Model ◽

Rank Test ◽

Anal Squamous Cell Carcinoma ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Kaplan Meier ◽

Increased Risk

3 Background: While treatment-related lymphopenia (TRL) is common and associated with poorer survival in multiple solid malignancies, little data exists for anal cancer. We evaluated TRL and its association with survival in anal cancer patients treated with chemoradiation (CRT). Methods: A retrospective analysis of 140 patients with non-metastatic anal squamous cell carcinoma (SCC) treated with definitive CRT was performed. Total lymphocyte counts (TLC) at baseline and monthly intervals up to 12 months after initiating CRT were analyzed. Multivariable Cox regression analysis was performed to evaluate the association between overall survival (OS) and TRL, dichotomized by G4 TRL ( < 0.2k/μl) two months after initiating CRT. Kaplan-Meier and log-rank tests were used to compare OS between patients with versus without G4 TRL. Results: Median time of follow-up was 55 months. Prior to CRT, 95% of patients had a normal TLC ( > 1k/μl). Two months after initiating CRT, there was a median of 71% reduction in TLC from baseline and 84% of patients had TRL: 11% G1, 31% G2, 34% G3, and 8% G4. On multivariable Cox model, G4 TRL at two months was associated with a 3.7-fold increased risk of death (p = 0.013). On log-rank test, the 5-year OS rate was shorter in the cohort with versus without G4 TRL at two months (32% vs. 86%, p < 0.001). Conclusions: TRL is common and may be another prognostic marker of OS in anal cancer patients treated with CRT. The association between TRL and OS supports the hypothesis that host immunity plays an important role in survival among patients with anal cancer. These results support ongoing efforts of randomized trials underway to evaluate the potential role of immunotherapy in localized anal cancer.

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Abstract WMP51: Ischemic Stroke Rates in Those With Diabetes in the Black and White Population: An Update

Stroke ◽

10.1161/str.51.suppl_1.wmp51 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Jane C Khoury ◽

Tracy Madsen ◽

Kathleen Alwell ◽

Charles J Moomaw ◽

Heidi Sucharew ◽

...

Keyword(s):

Local Population ◽

Age Groups ◽

Black Population ◽

Census Bureau ◽

Incidence Rates ◽

Black And White ◽

Increased Risk ◽

Diagnosed Diabetes ◽

Glycemic Monitoring ◽

Us Census

Background: We previously reported an increased incidence of stroke in the population with diabetes. This was particularly pronounced in those under 65 years of age. With guidelines now including glycemic monitoring during hospitalization, we examined incidence attributable to diabetes in 2010 and 2015. Methods: Ischemic strokes in the 5-county Greater Cincinnati/Northern Kentucky region were ascertained, then physician verified, at all 15 area hospitals using ICD-9 codes 430 to 436 or ICD10 codes I60 to I68. First ever ischemic strokes in patients aged 20 years and older were included in this analysis. Population age-specific rates of diabetes were estimated using the 2009-2010 and 2015-2016 NHANES databases, then applied to local population numbers, extracted from the US Census Bureau website, to estimate the denominator for calculation of incidence rates. Incidence rates were adjusted by age race and sex, as appropriate, to the 2010 US population. Diabetes was defined as reported in the electronic medical record or glycohemoglobin A1c &gt 6.4% during hospitalization. Results: There were a total of 4141 ischemic strokes; 55% female and 22% black. Stroke rates continue to be substantially higher in those with diagnosed diabetes, than those without diabetes overall and for those less than 65 years in both time periods, as well as those 65 years and older except for the black population in 2010. Racial disparities continue in both the less than 65 and 65 years and older age groups. Stroke rates were higher for Blacks in the less than 65 year age group for those both with and without diabetes; with risk ratios ranging from 1.3 to 2.7. Of note the stroke rate has decreased between 2010 and 2015 for those with diabetes <65 years of age. (Table) Conclusions: The population with diabetes continues to be at increased risk of stroke, especially in those less than 65 years of age and those of black race.

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