Incidence rates and symptomatology of community infections with SARS-CoV-2 in children and parents: The CoKids longitudinal household study

ABSTRACTAIMThe CoKids study aimed to estimate the community incidence of symptomatic and asymptomatic SARS-CoV-2 in children and parents and to assess the symptomatology of SARS-COV-2 infections relative to SARS-CoV-2 negative respiratory episodes.METHODSIn this prospective study, households with at least one child <18 years were recruited from three existing Dutch cohorts. Participation included SARS-CoV-2 screening at 4-6 weeks intervals for all household members during 23 weeks of follow-up and active reporting of new onset respiratory symptoms until July 1st 2021. Follow-up was temporarily intensified following new onset respiratory symptoms in a household member or a SARS-CoV-2 positive screening test and included daily symptom recording, repeated PCR testing (nose-throat, saliva and fecal samples) and SARS-CoV-2 antibody measurement (paired dried blood spots) in all household members. Age-stratified incidence rates for SARS-CoV-2 positive and negative episodes were calculated. Symptomatology and disease burden of respiratory episodes were compared by SARS-CoV-2 status and age.RESULTSIn total 307 households were enrolled including 1209 subjects. We detected 64 SARS-CoV-2 positive and 118 SARS-CoV-2 negative respiratory outbreaks. The highest incidence rate was found in children <12 years for SARS-CoV-2 negative episodes (0.93/ person-year (PY); 95%CI: 0.88-0.96). The SARS-CoV-2 incidence in this age-group was 0.21/PY for confirmed only, and 0.41/PY if probable cases were included. SARS-CoV-2 incidence did not differ by age group (p>0.27). Nasal congestion/runny nose, with or without cough and fatigue were the three most prevalent symptom clusters for both SARS-CoV-2 positive and negative respiratory episodes. Among children, no differences were observed in the symptomatology and severity of SARS-CoV-2 positive versus negative respiratory episodes, whereas among adults, SARS-CoV-2 positive episodes had a higher number and severity of symptoms and with a longer duration p<0.001).CONCLUSIONUsing active, longitudinal household follow up, we detected a high incidence rate of SARS-CoV-2 infections in children that was similar to adults. The findings suggest that after 20 months of COVID-19 pandemic, up to 2/3 of Dutch children < 12 years have been infected with SARS-CoV-2. Symptomatology and disease severity of SARS-CoV-2 in children is similar to respiratory illness from other causes. In adults, SARS-COV-2 positive episodes are characterized by more and prolonged symptoms, and higher severity. These findings may assist decisions on COVID-19 policies targeting children.

Download Full-text

Long-term (>10-year) clinical follow-up after young embolic stroke/TIA of undetermined source

International Journal of Stroke ◽

10.1177/1747493019884520 ◽

2019 ◽

pp. 174749301988452 ◽

Cited By ~ 2

Author(s):

M Nassif ◽

ME Annink ◽

H Yang ◽

TCD Rettig ◽

YBWEM Roos ◽

...

Keyword(s):

Incidence Rate ◽

Recurrent Stroke ◽

Young Patients ◽

Incidence Rates ◽

Embolic Stroke ◽

Vascular Events ◽

Tertiary Center ◽

New Onset

Background To date, the pathophysiology of first-ever and recurrent stroke/TIA still remains unclear in young patients with embolic stroke/TIA of undetermined source (ESUS). Clinical studies with long-term follow-up in young ESUS patients are necessary to investigate the underlying pathophysiology of first-ever and recurrent stroke/TIA in this patient population, in particular the role of new-onset atrial fibrillation. Aims Our aim was to study the long-term (>10-year) clinical outcome of young patients (<50 years) with ESUS. Methods This cohort study included all patients aged ≤ 50 years who underwent transoesophageal echocardiography for diagnostic work-up of ESUS during 1996–2008 from one tertiary center. All patients were contacted by telephone between September–November 2018 to update clinical information from medical records. The clinical outcomes of this study were incidence rates of all-cause and cardiovascular mortality, recurrent stroke/TIA, new-onset clinical AF, and ischemic vascular events. Results In total, 108 patients (57% female, mean age 40 ± 7.2 years [range 19–50 years], n = 72 stroke) were included. Across clinical follow-up (median 13[IQR 10–16] years), 24 patients died ( n = 14 cardiovascular). The 15-year incidence rate of recurrent stroke/TIA was 15% (incidence rate = 1.09[95%CI 0.54–1.65]/100 patient-years) and a 5.5% incidence of new-onset clinical AF (incidence rate = 0.44[95%CI 0.09–0.79]/100 patient-years) following ESUS. Conclusions The incidence of recurrent stroke/TIA is relatively high during long-term clinical follow-up of young patients with ESUS. In contrast, new-onset clinical AF is relatively low and therefore may not play an important part in the pathophysiology of first-ever and recurrent stroke/TIA of these patients.

Download Full-text

Exit strategies: optimising feasible surveillance for detection, elimination, and ongoing prevention of COVID-19 community transmission

BMC Medicine ◽

10.1186/s12916-021-01934-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

K. Lokuge ◽

E. Banks ◽

S. Davis ◽

L. Roberts ◽

T. Street ◽

...

Keyword(s):

Early Detection ◽

Respiratory Symptoms ◽

Respiratory Illness ◽

Reproductive Number ◽

Surveillance Strategy ◽

Transmission Chain ◽

Containment Measures ◽

Testing Uptake ◽

Community Transmission

Abstract Background Following implementation of strong containment measures, several countries and regions have low detectable community transmission of COVID-19. We developed an efficient, rapid, and scalable surveillance strategy to detect remaining COVID-19 community cases through exhaustive identification of every active transmission chain. We identified measures to enable early detection and effective management of any reintroduction of transmission once containment measures are lifted to ensure strong containment measures do not require reinstatement. Methods We compared efficiency and sensitivity to detect community transmission chains through testing of the following: hospital cases; fever, cough and/or ARI testing at community/primary care; and asymptomatic testing; using surveillance evaluation methods and mathematical modelling, varying testing capacities, reproductive number (R) and weekly cumulative incidence of COVID-19 and non-COVID-19 respiratory symptoms using data from Australia. We assessed system requirements to identify all transmission chains and follow up all cases and primary contacts within each chain, per million population. Results Assuming 20% of cases are asymptomatic and 30% of symptomatic COVID-19 cases present for testing, with R = 2.2, a median of 14 unrecognised community cases (8 infectious) occur when a transmission chain is identified through hospital surveillance versus 7 unrecognised cases (4 infectious) through community-based surveillance. The 7 unrecognised community upstream cases are estimated to generate a further 55–77 primary contacts requiring follow-up. The unrecognised community cases rise to 10 if 50% of cases are asymptomatic. Screening asymptomatic community members cannot exhaustively identify all cases under any of the scenarios assessed. The most important determinant of testing requirements for symptomatic screening is levels of non-COVID-19 respiratory illness. If 4% of the community have respiratory symptoms, and 1% of those with symptoms have COVID-19, exhaustive symptomatic screening requires approximately 11,600 tests/million population using 1/4 pooling, with 98% of cases detected (2% missed), given 99.9% sensitivity. Even with a drop in sensitivity to 70%, pooling was more effective at detecting cases than individual testing under all scenarios examined. Conclusions Screening all acute respiratory disease in the community, in combination with exhaustive and meticulous case and contact identification and management, enables appropriate early detection and elimination of COVID-19 community transmission. An important component is identification, testing, and management of all contacts, including upstream contacts (i.e. potential sources of infection for identified cases, and their related transmission chains). Pooling allows increased case detection when testing capacity is limited, even given reduced test sensitivity. Critical to the effectiveness of all aspects of surveillance is appropriate community engagement, messaging to optimise testing uptake and compliance with other measures.

Download Full-text

Age and Sex Specific Trends in Incidence of Juvenile Idiopathic Arthritis in Danish Birth Cohorts from 1992 to 2002: A Nationwide Register Linkage Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168331 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8331

Author(s):

Isabel Cardoso ◽

Peder Frederiksen ◽

Ina Olmer Specht ◽

Mina Nicole Händel ◽

Fanney Thorsteinsdottir ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Regression Model ◽

Incidence Rate ◽

Poisson Regression ◽

Linkage Study ◽

Incidence Rates ◽

Age Group ◽

Poisson Regression Model ◽

Birth Cohorts ◽

Age And Sex

This study reports age- and sex-specific incidence rates of juvenile idiopathic arthritis (JIA) in complete Danish birth cohorts from 1992 through 2002. Data were obtained from the Danish registries. All persons born in Denmark, from 1992–2002, were followed from birth and until either the date of first diagnosis recording, death, emigration, 16th birthday or administrative censoring (17 May 2017), whichever came first. The number of incident JIA cases and its incidence rate (per 100,000 person-years) were calculated within sex and age group for each of the birth cohorts. A multiplicative Poisson regression model was used to analyze the variation in the incidence rates by age and year of birth for boys and girls separately. The overall incidence of JIA was 24.1 (23.6–24.5) per 100,000 person-years. The rate per 100,000 person-years was higher among girls (29.9 (29.2–30.7)) than among boys (18.5 (18.0–19.1)). There were no evident peaks for any age group at diagnosis for boys but for girls two small peaks appeared at ages 0–5 years and 12–15 years. This study showed that the incidence rates of JIA in Denmark were higher for girls than for boys and remained stable over the observed period for both sexes.

Download Full-text

Vaccine impact and effectiveness of meningococcal serogroup ACWY conjugate vaccine implementation in the Netherlands: a nationwide surveillance study

Clinical Infectious Diseases ◽

10.1093/cid/ciab791 ◽

2021 ◽

Author(s):

Milou Ohm ◽

Susan J M Hahné ◽

Arie van der Ende ◽

Elizabeth A M Sanders ◽

Guy A M Berbers ◽

...

Keyword(s):

The Netherlands ◽

Incidence Rate ◽

Vaccination Programme ◽

Screening Method ◽

Age Groups ◽

Incidence Rates ◽

Age Group ◽

Mass Campaign ◽

Conjugate Vaccination ◽

The Impact

Abstract Background In response to the recent serogroup W invasive meningococcal disease (IMD-W) epidemic in the Netherlands, meningococcal serogroup C (MenC) conjugate vaccination for 14-month-olds was replaced with a MenACWY conjugate vaccination, and a mass campaign targeting 14-18 year-olds was executed. We investigated the impact of MenACWY vaccination implementation in 2018-2020 on incidence rates and estimated vaccine effectiveness (VE). Methods We extracted all IMD cases diagnosed between July 2014 and December 2020 from the national surveillance system. We calculated age group-specific incidence rate ratios by comparing incidence rates before (July 2017-March 2018) and after (July 2019-March 2020) MenACWY vaccination implementation. We estimated VE in vaccine-eligible cases using the screening method. Results Overall, IMD-W incidence rate lowered by 61% (95%CI 40-74). It declined by 82% (95%CI 18-96) in vaccine-eligible age group (15-36 month-olds and 14-18 year-olds) and by 57% (95%CI 34-72) in vaccine non-eligible age groups. VE was 92% (95%CI -20-99.5) against IMD-W vaccine-eligible toddlers. No IMD-W cases were reported in vaccine-eligible teenagers after the campaign. Conclusions The MenACWY vaccination programme was effective in preventing IMD-W in the target population. The IMD-W incidence reduction in vaccine non-eligible age groups may be caused by indirect effects of the vaccination programme. However, disentangling natural fluctuation from vaccine-effect was not possible. Our findings encourage the use of toddler- and teenager MenACWY vaccination in national immunization programmes especially when implemented together with a teenager mass campaign during an epidemic.

Download Full-text

Epidemiology of New Onset Seizures and Epilepsy Cases: A Prospective Cohort Study

International Journal of Epilepsy ◽

10.1055/s-0040-1712771 ◽

2020 ◽

Vol 06 (01) ◽

pp. 30-38

Author(s):

Deepak Goel ◽

Pradeep Aggarwal ◽

Sunil Dutt Kandpal ◽

Rakesh Kakkar ◽

Deepak Negi ◽

...

Keyword(s):

Incidence Rate ◽

Significant Risk ◽

Developed Countries ◽

Annual Incidence ◽

Time Interval ◽

Incidence Studies ◽

Adjusted Incidence Rate ◽

Adjusted Incidence ◽

New Onset

Abstract Introduction Incidence is the number of new epilepsy cases occurring during a given time interval, usually in 1 year, in a specified population. Most incidence studies of epilepsy are from developed countries with a rate of 40 to 70 per 100,000 population. Aims We conducted this survey to study incidence of all new onset unprovoked in rural and semiurban areas of the Uttarakhand State. This study is conducted on more than 100,000 of population with longitudinal follow-up of 3 years. Methods This was a community-based, longitudinal, observational study in two blocks of Dehradun district of Uttarakhand state. Total population of approximately 100,000 from two blocks will be surveyed (50,000 in each block). This door-to-door survey was conducted annually for 3 years duration from May 2014 to April 2017. The initial data were collected on National Institute of Mental Health and Neurosciences (NIMHANS) questionnaire by door-to-door survey. Results After longitudinal follow-up for 3 years of 103,610 of population in two blocks of Uttarakhand state, we found age-adjusted prevalence rate of unprovoked seizures to the tune of 623.63 cases per 100,000 of population. Age-adjusted incidence rate of epilepsy was 38.28 per 100,000 population and annual incidence of acute symptomatic seizures was 14.79 per 100,000 of population. Overall annual incidence rate of all afebrile seizures was 51.63 per of 100,000 people. Among all sociodemographic factors, age, poverty, diet, and hygiene were significantly associated with seizures. Conclusion Age-adjusted incidence rate of unprovoked seizure in Uttarakhand state was 38.28 per 100,000 people. Diet and hygiene were significant risk factors for seizures.

Download Full-text

The association between carotid intima-media thickness and new-onset hypertension in a Chinese community-based population

BMC Cardiovascular Disorders ◽

10.1186/s12872-019-1266-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Long Zhang ◽

Fangfang Fan ◽

Litong Qi ◽

Jia Jia ◽

Ying Yang ◽

...

Keyword(s):

Blood Pressure ◽

Strong Association ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Incidence Rates ◽

Community Based ◽

Media Thickness ◽

The Mean ◽

New Onset

Abstract Background Hypertension and arterial vasculopathy may be mutual causes and effects. It is unknown whether carotid intima-media thickness (cIMT) is reliably predictive of the presence of newly developed hypertension in the Chinese population. This study evaluated the impacts of cIMT on new-onset hypertension in a community-based population without hypertension at baseline in China. Methods A total of 672 Chinese subjects who had complete data for demographics, baseline and follow-up blood pressure measurements, and cIMT measurements at baseline were included in our study. Baseline cIMT was obtained under standardized procedures using the GE Vivid 7 ultrasound system equipped with an 8-MHz linear array vascular probe (GE Medical Systems, Milwaukee, Wl, USA). The outcome was the incidence of hypertension at follow-up. Multivariate regression models were used to access the association between baseline cIMT and the risk of new-onset hypertension. Results Subjects were 51.5 ± 4.7 years old, and 32.0% were male. The mean baseline systolic blood pressure (SBP) was 122.5 ± 10.0 mmHg. The mean baseline diastolic blood pressure (DBP) was 72.4 ± 7.5 mmHg. The number of subjects with thickened cIMT (maximum ≥0.9 mm) at baseline was 198 (29.5%). After 2.3 years of follow-up, the rate of new-onset hypertension was 12.6%. The incidence rates of hypertension in the groups with thickened cIMT and normal cIMT were 19.2 and 9.9%, respectively. In the multivariable logistic regression analyses, both the average (OR = 1.69, 95% CI: 1.30–2.19, P = 0.0001) and maximum (OR = 1.55, 95% CI: 1.23–1.95, P = 0.0002) cIMT were significantly associated with new-onset hypertension after adjustment for various confounders. The group with thickened cIMT showed a higher risk for the incidence of hypertension, with an OR of 1.82 (95% CI: 1.07–3.10, P = 0.0270), compared to the normal group. Conclusion Thickened cIMT has a strong association with incident hypertension risk in a community-based population without hypertension at baseline in China.

Download Full-text

Incidence of extra-articular manifestations in ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis: results from a national register-based cohort study

Rheumatology ◽

10.1093/rheumatology/keaa692 ◽

2020 ◽

Author(s):

Karin Bengtsson ◽

Helena Forsblad-d'Elia ◽

Anna Deminger ◽

Eva Klingberg ◽

Mats Dehlin ◽

...

Keyword(s):

Incidence Rate ◽

Incidence Rates ◽

The Other ◽

Population Register ◽

Swedish Population ◽

National Patient Register ◽

National Patient ◽

Rate Ratios ◽

Strength Of Association

Abstract Objectives To estimate the incidence and strength of association of extra-articular manifestations [EAMs, here: anterior uveitis (AU), IBD and psoriasis] in patients with AS, undifferentiated SpA (uSpA) and PsA, compared with controls. Methods Three mutually exclusive cohorts of patients aged 18–69 years with AS (n = 8517), uSpA (n = 10 245) and PsA (n = 22 667) were identified in the Swedish National Patient Register 2001–2015. Age-, sex- and geography-matched controls were identified from the Swedish Population Register. Follow-up began 1 January 2006, or six months after the first SpA diagnosis, whichever occurred later, and ended at the first date of the EAM under study, death, emigration, 70 years of age, and 31 December 2016. Incidence rates (IRs) and incidence rate ratios were calculated for each EAM, and stratified by sex and age. Results Incidence rate ratios for incident AU, IBD and psoriasis were significantly increased in AS (20.2, 6.2, 2.5), uSpA (13.6, 5.7, 3.8) and PsA (2.5, 2.3, n.a) vs controls. Men with AS and uSpA had significantly higher IRs per 1000 person-years at risk for incident AU than women with AS (IR 15.8 vs 11.2) and uSpA (IR 10.1 vs 6.0), whereas no such sex difference was demonstrated in PsA or for the other EAMs. Conclusions AU, followed by IBD and psoriasis, is the EAM most strongly associated with AS and uSpA. Among the SpA subtypes, AS and uSpA display a largely similar pattern of EAMs, whereas PsA has a considerably weaker association with AU and IBD.

Download Full-text

Assessment of Late Thromboembolic Complications Post–Fontan Procedure in Relation to Different Antithrombotic Regimens: 30-Years’ Follow-up Experience

Annals of Pharmacotherapy ◽

10.1177/1060028019829860 ◽

2019 ◽

Vol 53 (8) ◽

pp. 786-793

Author(s):

Abdulrazaq S. Al-Jazairi ◽

Hana A. Al Alshaykh ◽

Giovanni Di Salvo ◽

Edward B. De Vol ◽

Zohair Y. Alhalees

Keyword(s):

Incidence Rate ◽

Rate Ratio ◽

Fontan Procedure ◽

Incidence Rates ◽

Drug Selection ◽

Thromboembolic Complications ◽

Inclusion Criteria ◽

Duration Of Therapy ◽

The Difference

Background: The current CHEST guidelines recommend the use of antithrombotic therapy, either aspirin or warfarin, as a primary thromboembolic complications (TECs) prophylaxis in patients who undergo Fontan procedure, without specification on drug selection or duration of therapy. Objective: To investigate the incidence rate of late TECs, occurring after 1-year post–Fontan procedure and to assess the difference in rate of late TECs between warfarin and aspirin. Methods: A retrospective cohort study included patients who had Fontan procedures between 1985-2010 at our institution. Patients were stratified according to the antithrombotic regimen—warfarin, aspirin, or no therapy—at the time of TECs. Results: We screened 499 patients who underwent Fontan procedures; 431 procedures met the inclusion criteria. Over a median follow-up of 13.6 years (IQR= 8.7), freedom from late TECs at 5, 10, 15, and 20 years was 97.54%, 96.90%, 90.78%, and 88.07%, respectively. There was no difference in late TEC incidence rates per 1000 patient-years between warfarin and aspirin: 7.82 and 5.83 events, respectively; rate ratio= 1.34 (95% CI= 0.68-2.60). Warfarin was associated with a higher major bleeding incidence rate per 1000 patient-years: 3.70 versus 2.91 events with aspirin; rate ratio= 1.27 (95% CI= 0.49 to 3.29). Conclusion and Relevance: The incidence rate of late clinical TECs post–Fontan procedure in our population is low. Warfarin was not superior to aspirin for prevention of late TECs. Yet warfarin was associated with a higher rate of bleeding. This finding suggests a simpler antithrombotic regimen for prevention of TEC after 1-year post-Fontan procedure.

Download Full-text

Higher Incidence of Chronic Myeloid Leukemia (CML) Among Blacks Compared to Whites in the Post-Imatinib Period (2002–2009) Corresponds with Worse Survival Observed within the Surveillance, Epidemiology and End Results 18 Registries

Blood ◽

10.1182/blood.v120.21.3773.3773 ◽

2012 ◽

Vol 120 (21) ◽

pp. 3773-3773

Author(s):

Adam Mendizabal ◽

Paul H Levine

Keyword(s):

Tyrosine Kinase ◽

Incidence Rate ◽

Kinase Inhibitors ◽

Age Groups ◽

Incidence Rates ◽

Age At Diagnosis ◽

Age Group ◽

Risk Of Death ◽

Younger Age ◽

Adjusted Incidence

Abstract Abstract 3773 Background: Age at diagnosis of CML varies by race in the United States with median occurring around ages 54 and 63 among Black and White patients, respectively. The treatment paradigm shifted when Imatinib was approved in 2001 for treatment of CML. More recently, second generation tyrosine kinase inhibitors (TKI) have also been used for treatment of CML. Differences in outcomes by race have been previously reported prior to the TKI treatment period. We aimed to assess whether the earlier age at diagnosis resulted in differential trends in age-adjusted incidence rates and survival outcomes by race in the post-Imatinib treatment period. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) 18 Registries were extracted for diagnoses between 2002 and 2009 based on the assumption that cases diagnosed after 2002 would be treated with TKI's. CML was defined according to the International Classification of Diseases for Oncology 3rd edition code 9863 (CML-NOS) and 9875 (CML-Philadelphia Chromosome Positive). Cases diagnosed by autopsy or death certificate only were excluded. Incidence rates are expressed per 100,000 person-years and age-adjusted to the 2000 US Standard Population. Black/White incidence rate ratios (IRRBW) are shown with corresponding 95% confidence intervals (CI). Kaplan-Meier estimates of CML-specific survival (CPS) and overall survival (OS) were estimated at 5-years post-diagnosis with the event being time to CML-specific death or any death, respectively. Stratified Cox proportional hazards models were constructed to assess the impact of age and race on the risk of death expressed as a hazard ratio (HR). Results: Since 2002, 6,632 patients diagnosed with CML were reported to the SEER 18 registries including 5,829 White patients (87.9%) and 803 Black patients (12.1%) with 57% being male. The age-adjusted incidence rate for Blacks was 1.18 (95% CI, 1.10–1.27) per 100,000 and 1.12 (95% CI, 1.09–1.27) per 100,000 for Whites. The corresponding IRRBW was 1.06 (95% CI, 0.98– 1.14). When considering 20-year age-groups, Blacks had higher incidence rates in the 20–39 and 40–59 age groups; IRRBW of 1.26 (95% CI, 1.06–1.49; p=0.0073) and 1.23 (95% CI, 1.09–1.39; p=0.0007), respectively. No statistically significant differences in IRRBW were seen within the 0–19, 60–79 and 80+ age-groupings although Whites have higher non-significant incidence rates in the latter 2 age-groups. Differences in IRRBW prompted an assessment of survival to determine if the excess incidence observed in the younger age groups corresponded with a worse survival. CPS at 5-years was 85.5% (95% CI, 84.3–86.6). In univariate analysis, age was an important predictor of outcome (p<0.0001) with patients diagnosed after age 80 having the worse outcomes (OS: 58.3%), followed by patients diagnosed between 60 and 79 years (OS 84.7%), 0–19 years (OS: 87.1%), 40–59 years (OS: 90.2%), and 20–39 years (OS: 92.6%). When considering all age-groups, race was not a significant predictor of death (HR 0.91; 95% CI, 0.72–1.15). However, in a stratified analysis with 20-year age groups, Blacks had an increased risk of death as compared to Whites (Figure 1) in the 20–39 age group (HR: 2.94; 95% CI, 1.72–5.26; p<0.0001) and the 40–59 age group (HR: 1.67; 95% CI, 1.22–2.27; p=0.0069) while no differences were seen within the 0–19, 60–79 and 80+ age groups. Conclusions from OS models were similar to that of the CPS models. Conclusions: Through this analysis of population-based cancer registry data collected in the US between 2002 and 2009, we show that Blacks have a younger age at diagnosis with higher incidence rates observed in the 20–39 and 40–59 age-groups as compared to Whites. Both CPS and OS outcomes differed by race and age. Similar to the differences observed with the incidence rates, survival was worse in Blacks diagnosed within the 20–39 and 40–59 age-groups as compared to Whites. Although outcomes have globally improved in patients with CML since the advent of tyrosine kinase inhibitors, the persistence of incidence heterogeneity and poorer survival among Blacks warrants further attention. Access to care may be a possible reason for the differences observed but further studies are warranted to rule out biological differences which may be causing an earlier age at onset and poorer survival. Disclosures: No relevant conflicts of interest to declare.

Download Full-text

Breast cancer incidence in a large cohort of Peruvian women affiliated to a pre-paid system.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e12570 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e12570-e12570

Author(s):

Juan F. Suazo ◽

Priscila I. Valdiviezo ◽

Claudio J. Flores ◽

Jorge Iberico ◽

Joseph A. Pinto ◽

...

Keyword(s):

Breast Cancer ◽

At Risk ◽

General Population ◽

Incidence Rate ◽

Breast Cancer Incidence ◽

Age Groups ◽

Cumulative Risk ◽

Incidence Rates ◽

Specific Rate ◽

Age Group

e12570 Background: Breast cancer (BC) is the second most common malignancy and the leading cause of death by cancer in Peruvian women (age-standarized rate [ASR] of 34 new cases/100,000 women estimated by GLOBOCAN 2008). The purpose of this study was to assess the incidence of BCin acohort ofwomenat Oncosalud, an oncologic pre-paid system that currently has 600,000 affiliates. Methods: We evaluated a dynamic cohort (period 1989 to 2011) of women affiliatedat Oncosalud – AUNA, an oncologic prepaid system.The crude incidence rate per year (number of new cases/women at risk), the specific rate according to age (number of new cases / persons-year) and cumulative risk were calculated. Results: Overall, during the assessment period, the BC incidence rate per year was 175.6 and the ASR incidence was 111.9 per 100,000 affiliates respectively. In our cohort of affiliates there were no BC cases before 1993 (with 907 women at risk for that year). The highest incidence rate was 177.6 registered in 1997 (11,822 women at risk). Incidence rates started decreasing in 2003 (169.2 with a population at risk of 39,593 women). The lowest incidence was 71.5, registered in 2011 (279,680 women at risk).According to age-groups, there were no BC cases under20 years old. Specificincidence ratesper age-group increases from the 30 year old-group (55.8). The peak of BC incidence was between 70 to 74 years old (407.4). In the same way, the cumulative risk increases after 30 years old. Conclusions: In our cohort of affiliates, the incidence of BC is greater than the general population, it could be due to the process of negative selection; however, specific incidence rates per age-group and cumulative risk are increased after 30 years, as seen in the general population.

Download Full-text