scholarly journals Incidence rates of systemic lupus erythematosus in the USA: estimates from a meta-analysis of the Centers for Disease Control and Prevention national lupus registries

2021 ◽  
Vol 8 (1) ◽  
pp. e000614
Author(s):  
Peter M Izmirly ◽  
Elizabeth D Ferucci ◽  
Emily C Somers ◽  
Lu Wang ◽  
S Sam Lim ◽  
...  

ObjectiveTo estimate the annual incidence rate of SLE in the USA.MethodsA meta-analysis used sex/race/ethnicity-specific data spanning 2002–2009 from the Centers for Disease Control and Prevention network of four population-based state registries to estimate the incidence rates. SLE was defined as fulfilling the 1997 revised American College of Rheumatology classification criteria. Given heterogeneity across sites, a random effects model was employed. Applying sex/race/ethnicity-stratified rates, including data from the Indian Health Service registry, to the 2018 US Census population generated estimates of newly diagnosed SLE cases.ResultsThe pooled incidence rate per 100 000 person-years was 5.1 (95% CI 4.6 to 5.6), higher in females than in males (8.7 vs 1.2), and highest among black females (15.9), followed by Asian/Pacific Islander (7.6), Hispanic (6.8) and white (5.7) females. Male incidence was highest in black males (2.4), followed by Hispanic (0.9), white (0.8) and Asian/Pacific Islander (0.4) males. The American Indian/Alaska Native population had the second highest race-specific SLE estimates for females (10.4 per 100 000) and highest for males (3.8 per 100 000). In 2018, an estimated 14 263 persons (95% CI 11 563 to 17 735) were newly diagnosed with SLE in the USA.ConclusionsA network of population-based SLE registries provided estimates of SLE incidence rates and numbers diagnosed in the USA.

2011 ◽  
Vol 140 (3) ◽  
pp. 566-574 ◽  
Author(s):  
S. A. LOWTHER ◽  
N. SHINODA ◽  
B. A. JUNI ◽  
M. J. THEODORE ◽  
X. WANG ◽  
...  

SUMMARYAn increase in invasiveHaemophilus influenzaetype b (Hib) cases occurred in Minnesota in 2008 after the recommended deferral of the 12–15 months Hib vaccine boosters during a US vaccine shortage. Five invasive Hib cases (one death) occurred in children; four had incomplete Hib vaccination (three refused/delayed); one was immunodeficient. Subsequently, we evaluated Hib carriage and vaccination. From 18 clinics near Hib cases, children (aged 4 weeks–60 months) were surveyed for pharyngeal Hib carriage. Records were compared for Hib, diphtheria-tetanus-acellular pertussis (DTaP), and pneumococcal (PCV-7) vaccination. Parents completed questionnaires on carriage risk factors and vaccination beliefs. In 1631 children (February–March 2009), no Hib carriage was detected; Hib vaccination was less likely to be completed than DTaP and PCV-7. Non-type bH. influenzae, detected in 245 (15%) children, was associated with: male sex, age 24–60 months, daycare attendance >15 h/week, a household smoker, and Asian/Pacific Islander race/ethnicity. In 2009, invasive Hib disease occurred in two children caused by the same strain that circulated in 2008. Hib remains a risk for vulnerable/unvaccinated children, although Hib carriage is not widespread in young children.


2020 ◽  
Vol 2020 (4) ◽  
Author(s):  
Abhiman Cheeyandira

Abstract Corona virus pandemic has affected all the 50 states in the USA. States such as NY, CA and WA being the most affected. According to the Centers for Disease Control and Prevention (CDC) website, as of 28 March 2020, the total number of cases in the USA is over 103 300 and number of deaths to 1668. In the coming weeks, COVID-19 rates are expected to begin skyrocketing and hit a peak in late April/May/June given lessons learned from China, Italy and others. COVID-19 has been declared a pandemic by the World Health Organization (WHO) as confirmed cases approach 575 444 patients with 26 654 deaths across over 160 countries, as of 28 March 2020. There is a lot of impact on management of the urgent and emergent cases. This article highlights the changes that are being made in delivering urgent and emergent surgical care during the pandemic.


2018 ◽  
Vol 110 (11) ◽  
pp. 1259-1269 ◽  
Author(s):  
Christopher Pham ◽  
Tse-Ling Fong ◽  
Juanjuan Zhang ◽  
Lihua Liu

AbstractBackgroundHepatocellular carcinoma (HCC) is characterized by disparate risk patterns by race/ethnicity. We examined HCC incidence patterns and temporal trends among detailed racial/ethnic populations, including disaggregated Asian-American subgroups.MethodsUsing data from the population-based California Cancer Registry, we identified 41 929 invasive HCC cases diagnosed during 1988–2012. Patients were grouped into mutually exclusive racial/ethnic groups of non-Hispanic (NH) white, NH black, Hispanic, and NH Asian/Pacific Islander (API), as well as Asian subgroups of Chinese, Filipino, Japanese, Korean, Vietnamese, Cambodian, Laotian, and South Asian. Age-adjusted and age-specific incidence rates by sex, race/ethnicity, and time period were calculated. The average annual percent change (AAPC) in incidence rates was estimated using joinpoint regression. All estimates were provided with the 95% confidence intervals (CIs).ResultsAggregated NH API had higher HCC risk than NH whites, NH blacks, and Hispanics. When disaggregated, Southeast Asians (Vietnamese, Cambodians, and Laotians) had overall HCC incidence rates eight to nine times higher than NH whites and more than twice that of other ethnic Asians. Statistically significant rising temporal trends of HCC were found in NH whites, NH blacks, and Hispanics, especially those older than age 50 years. Overall HCC risk declined in Chinese males (AAPC = –1.3%, 95% CI = –2.0 to –0.6), but rose in Filipino (AAPC = +1.2%, 95% CI = 0.3 to 2.1) and Japanese males (AAPC = +3.0%, 95% CI = 0.4 to 5.6) and Vietnamese (AAPC = +4.5%, 95% CI = 0.7 to 8.5) and Laotian (+3.4%, 95% CI = 0.1 to 6.8) females.ConclusionsOur findings provide valuable information for the identification of at-risk ethnic subgroups of Asian Americans while underscoring the importance of disaggregating ethnic populations in cancer research.


2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 71-73
Author(s):  
J A Osei ◽  
J Peña-Sánchez ◽  
S Fowler ◽  
N Muhajarine ◽  
G G Kaplan ◽  
...  

Abstract Background Canada has one of the highest inflammatory bowel disease (IBD) incidence rates worldwide, although within Canada rates vary. Evidence show increasing incidence rates of IBD in Ontario (i.e. adults aged 30–60), stable in Alberta and decreasing in Manitoba. Additionally, higher incident rates of IBD have been identified among urban regions compared to rural regions. There is limited data on the incidence of IBD in Saskatchewan. Aims The study objectives were to 1) estimate IBD incidence rates in Saskatchewan from 1999 to 2016, and 2) test for differences in IBD incidence rates for rural and urban regions of Saskatchewan. Methods A population-based study was conducted using linked provincial administrative health databases. Individuals age 18+ old with newly diagnosed Crohn’s disease (CD) or ulcerative colitis (UC) were identified using a validated case definition. Generalized linear models with a negative binomial distribution were used to estimate incidence rates and incidence rate ratios (IRR) adjusted for age group, sex, and rurality with 95% confidence intervals (95%CI). Results In total, 4,908 newly diagnosed individuals with IBD were included. The average annual incidence rate of IBD decreased from 75 (95%CI 67–84) per 100,000 people in 1999 to 15 (95%CI 12–18) per 100,000 population in 2016. This decrease was evident in both UC (from 36/100,000 [95%CI 31–42] in 1999 to 6/100,000 [95%CI 4–8] in 2016) and CD (37/100,000 [95%CI 32–42] in 1999 to 8/100,000 [95%CI 6–10] in 2016). A significant decline of 6.9% (95%CI 6.2–7.6) in the average annual incidence of IBD was estimated between 1999 and 2016 (see Figure 1). Urban residents had a greater overall risk of IBD (IRR=1.19, 95%CI 1.11–1.27) than rural residents. This risk difference was statistically significant for CD (IRR=1.25, 95%CI 1.14–1.36), but not UC (IRR=1.08, 95%CI 0.97–1.19). Conclusions A decreasing trend in IBD incidence in Saskatchewan was identified after adjusting for age group, sex, and rural/urban region of residence. Around 150 new cases of IBD are still diagnosed annually in Saskatchewan, but this estimate is lower than estimates from other provinces. Urban dwellers have a 25% higher risk of CD onset compared to their rural counterparts. This finding could suggest the presence of specific risk factors in urban settings that require further investigation. Health care providers and decision-makers should plan IBD-specific health care programs taking into account these specific IBD rates in Saskatchewan. Funding Agencies College of Medicine, University of Saskatchewan


2018 ◽  
Vol 103 (6) ◽  
pp. 2182-2188 ◽  
Author(s):  
Jakob Dal ◽  
Michelle Z Leisner ◽  
Kasper Hermansen ◽  
Dóra Körmendiné Farkas ◽  
Mads Bengtsen ◽  
...  

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.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4913-4913
Author(s):  
Aaron T Gerds ◽  
Laura C Michaelis ◽  
Danielle Shafer

Abstract Abstract 4913 Background: The addition of rituximab to cytotoxic chemotherapy has become standard in the initial treatment of DLBCL. However, estimations of the overall effect of the addition of rituximab to chemotherapy vary widely in the published literature. To date, no meta-analyses of rituximab in DLBCL have been published. We performed a comprehensive systematic review to compare chemotherapy with rituximab-chemotherapy in studies of newly-diagnosed DLBCL. The primary endpoint was OS; additional endpoints included disease control (DC), complete response (CR), and regimen-related toxicity (RRT). Disease control was assessed in each study as the time to treatment failure, event-free survival, progression free survival or time to progression. Methods: A comprehensive search for randomized trials (RCTs) comparing the addition of rituximab to chemotherapy was conducted in MEDLINE (January 1997 through April 2010). Also, meeting proceedings from American Society of Clinical Oncology, American Society of Hematology, European Society of Clinical Oncology and European Hematology Association, and studies listed on www.clinicaltrials.gov were manually searched for any supplementary abstracts, presentations or updates that were not identified in the original database search. The analysis included only RCTs comparing rituximab-chemotherapy with chemotherapy alone in patients with newly diagnosed DLBCL. Chemotherapy regimens were limited to CHOP or CHOP-like regimens. All three authors independently assessed each study's quality and performed blinded data extraction with conflict resolution by majority consensus. Given the inclusion of studies with both young and elderly patients, as well as HIV seropositive patients, we pooled data using a random effects model, with the estimate of heterogeneity being taken from the inverse variance fixed effect model. Results: Overall, seven RCTs involving 3539 patients with newly diagnosed DLBCL met inclusion criteria and were included in the meta-analysis. All studies were published as full-text articles. None of the studies were blinded. Studies from North America, Central America, and Europe were incorporated. The funnel plot for OS and Egger's test (1.37; 95% CI -2.25 to 4.99) did not indicate a significant publication bias. The test of heterogeneity among all RCTs was statistically significant in all endpoints. The pooled odds ratio (OR) demonstrated an increased OS for patients treated with rituximab-chemotherapy compared to chemotherapy alone (OR 0.71; 95% CI: 0.57 to 0.89). Similar improvements in CR (OR 1.64; 95% CI: 1.23, 2.17) and DC (OR 0.56; 95% CI: 0.46, 0.70) were observed in the patients treated with the rituximab containing regimens. Due to variable RRT reporting across studies, a formal meta-analysis of toxicity was not completed. In addition, varied data reporting precluded formal analysis of any differences in benefit between the International Prognostic Index groups. Conclusions: Our meta-analysis of data from more than 3500 patients with newly diagnosed DLBCL demonstrates that the addition of rituximab to chemotherapy improves the odds of OS and DC by 29% and 44%, respectively, as compared to chemotherapy alone. The survival benefit was independent of age (data not shown). This comprehensive systematic analysis enumerates and confirms the benefit of rituximab-based therapy in previously untreated DLBCL. Forest Plot for OS. Disclosures: No relevant conflicts of interest to declare.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1554-1554
Author(s):  
Carol Parise ◽  
Vincent Caggiano

1554 Background: Black men with breast cancer have more concomitant disease and worse survival than white men. Less is known about concomitant disease and survival in Hispanic and Asian/Pacific Islander (API) men with breast cancer. The purpose of this study was to compare differences in survival and risk of mortality of white, black, Hispanic, and Asian/Pacific Islander (API) men with breast cancer with increasing comorbidity. Methods: We identified 1,497 cases of first primary male invasive breast cancer from the California Cancer Registry 2000-2015 with a documented Charlson Comorbidity Index (CCI). The CCI is a weighted index based on the presence of certain comorbid conditions following a cancer diagnosis and weighted by the severity of these conditions. A score of 0 indicates no significant comorbidity and scores of 2 or more are interpreted as a high comorbidity burden. Bivariate associations between race and AJCC stage, tumor grade, estrogen receptor (ER) status, human epidermal growth factor 2 (HER2), and socioeconomic status (SES) were compared using the χ2 Test of Independence. Kaplan Meier Survival analysis was used to compare unadjusted survival among the races. Cox Regression was used to assess risk of mortality for each race when adjusted for factors that had a statistically significant (p < 0.10) bivariate association with race/ethnicity. Analyses were conducted within each level of the CCI (0, 1, and 2 or more). Results: Among men with a CCI of 0 or 2, blacks had worse unadjusted survival than whites. There were no differences in survival for men with a CCI of 1. Stage, SES, ER, and type of surgery all had statistically significant bivariate associations with race/ethnicity. For men with a CCI of 0, Hispanics (HR = 0.367; 95% CI = 0.167, 0.801) and APIs (HR = 0.422; 95% CI = 0.189, 0.941) had a reduced risk of mortality when compared with whites. Black men had the same risk of mortality as white men. There were no differences in risk of mortality by race for men with a CCI of 1 or 2. Conclusions: Black men with breast cancer and no comorbidity have the same risk of mortality as white men while Hispanic and API men have lower risk of mortality. There are no racial disparities in adjusted risk of mortality in men with breast cancer with any concomitant disease.


Blood ◽  
2009 ◽  
Vol 113 (21) ◽  
pp. 5064-5073 ◽  
Author(s):  
Porcia T. Bradford ◽  
Susan S. Devesa ◽  
William F. Anderson ◽  
Jorge R. Toro

Abstract There have been no prior large population-based studies focusing on cutaneous lymphomas (CL) in the United States. Using the Surveillance, Epidemiology and End Results (SEER) program data, we analyzed age-adjusted CL incidence rates (IRs) and survival rates by sex and race/ethnicity. There were 3884 CLs diagnosed during 2001-2005. Cutaneous T-cell lymphomas (CTCLs) accounted for 71% (age-adjusted incidence rate [IR] = 7.7/1 000 000 person-years), whereas cutaneous B-cell lymphomas(CBCLs) accounted for 29% (IR = 3.1/1 000 000 person-years). Males had a statistically significant higher IR of CL than females (14.0 vs 8.2/1 000 000 person-years, respectively; male-female IR ratio [M/F IRR] = 1.72; P < .001). CL IRs were highest among blacks and non-Hispanic whites (both 11.5/1 000 000 person-years), followed by Hispanic whites (7.9) and Asian/Pacific Islanders (7.1). The CTCL IR was highest among blacks (10.0/1 000 000 person-years), whereas the CBCL IR was highest among non-Hispanic whites (3.5). Over the past 25 years, the CL IR increased from 5.0/1 000 000 person-years during 1980-1982 to 14.3 during 2001-2003. During 2004-2005, the CL IR was 12.7. This recent apparent change could be incomplete case ascertainment or potential leveling off of IRs. CLs rates vary markedly by race and sex, supporting the notion that they represent distinct disease entities.


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