Incidence Rates of the Leukemias in the United States Are Significantly Associated with Birth Cohort,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4203-4203
Author(s):  
Philip S Rosenberg ◽  
William F. Anderson
Keyword(s):  
United States ◽  
Birth Cohort ◽  
Conflicts Of Interest ◽  
Pediatric Population ◽  
The United States ◽  
Incidence Rates ◽  
Cohort Effects ◽  
Major Type ◽  
Nationally Representative ◽  
Pediatric Aml

Abstract 4203 BACKGROUND: Leukemia (all types) is a common cancer in the United States (US) with 44,600 new cases expected in 2011. There are currently only a few established risk factors for any major type. If leukemia risks are substantially modulated by known or unknown environmental and lifestyle exposures, then incidence rates in the population should vary significantly by birth cohort. However, prior studies have not examined birth cohort effects using contemporary data and methods. METHODS: We used nationally representative data from the National Cancer Institute's Surveillance, Epidemiology and End Results Program for 1992 – 2008 (68,481 leukemias and 6.6×108 person-years of follow-up). For each major type in male and female pediatric (ages 0 – 17) and adult (ages 18 – 85) populations, we estimated the average annual percentage change in incidence attributable to calendar period and/or birth cohort (net drift), and the significance of unique (non-linear) birth cohort effects, using age-period-cohort statistical models and Poisson regression. RESULTS: In adults, birth cohort effects for AML were significant in men (P = 0.002) and borderline significant in women (P = 0.053). Compared to men born during 1947 – 1951, men born in the 1920s–1930s were 1.4-fold more likely to develop AML; AML rates were stable in men born after 1951. Birth cohort patterns for AML were qualitatively similar in women compared to men. For CLL, birth cohort effects were highly significant in men (P=5.7×10−6), peaking among men born circa 1939 and falling by 38% among men born circa 1963. In contrast, birth cohort effects for CLL were almost completely absent in women. For CML, incidence declined steadily by 1.3%/year among men (P = 0.0003) and by 1.5%/year among women (P = 0.0008). For ALL, incidence increased steadily by 2.0%/year among women (P = 0.001); birth cohort patterns were similar in men but not statistically significant (P = 0.36). In the pediatric population, AML rates were stable over time. In contrast, ALL rates increased by 1.4%/year among males (P = 0.001) and by 1.1%/year among females (P=0.04). CONCLUSIONS: In the US, leukemia risks increase or decrease substantially by birth cohort for each major leukemia type except adult female CLL and pediatric AML, on the order of 1–2%/year or 20–40% per generation. These results are consistent with the hypothesis that leukemia risks are substantially affected by known (i.e. smoking, certain chemicals) or suspected (i.e. obesity) environmental and lifestyle exposures, a number of which are potentially modifiable. Disclosures: No relevant conflicts of interest to declare.

Abstract P204: Birth Cohort Effects and Lipid Trends—The Impact of the Obesity Epidemic: Evidence From Cohorts Born Between 1930 and 1998 in the United States

Circulation ◽  
2019 ◽  
Vol 139 (Suppl_1) ◽  
Author(s):  
Thanh-Huyen T Vu ◽  
Donald Lloyd-Jones ◽  
Mercedes R Carnethon ◽  
John T Wilkins ◽  
Hy Tran ◽  
...  
Keyword(s):  
United States ◽  
Birth Cohort ◽  
The United States ◽  
Cohort Effects ◽  
Obesity Epidemic ◽  
The Impact

Incidence and Survival Outcomes Of Myelodysplastic Syndrome In The United States: A SEER Analysis 2001 - 2010

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5205-5205
Author(s):  
Hari Prasad Ravipati ◽  
Srinadh Annangi ◽  
Vamsi Kota
Keyword(s):  
United States ◽  
Median Survival ◽  
Conflicts Of Interest ◽  
Large Population ◽  
Survival Rates ◽  
Relative Survival ◽  
The United States ◽  
Incidence Rates ◽  
Significant Difference ◽  
Metropolitan Counties

Abstract Introduction Myelodysplastic syndromes (MDS) are a group of hematological disorders leading to ineffective hematopoiesis and excess blast formation. We aimed to establish the incidence rates and median survival periods in MDS by gender, race and geographic location in a large population cohort. Methods We performed a retrospective analysis of the United States (US) SEER database for MDS cases diagnosed between 2001 and 2010 using ICD-0-3 histology codes 9980/3, 9982/3, 9983/3, 9984/3 and 9986/3. Incidence rates were calculated using the 2000 US standard population. Five-year relative survival rates were measured using the Kaplan-Meier method after excluding cases diagnosed by death certificate and autopsy. Results 14,920 cases were identified of which 87.2 % (n = 13,009) were present in age group sixty years and above. Age-adjusted incidence rates (per 100,000) for males were 14.8, 10.0, and 12.7 for white, black and other races respectively. The rates for females were 7.7, 7.1, and 7.0. On US county wise MDS case analysis, 11296 (86.8%) of cases were diagnosed in metropolitan counties and 1694 (13%) cases in nonmetropolitan counties. Median relative survival for white, black and other males were 27 months, 36 months and 24 months respectively ; 35 months, 38 months and 37 months for females. Five-year relative survival for white, black, and other males were 32.5% (95% CI 30.7- 34.3), 36.1% (95% CI 28.3 - 43.9) and 30% (95% CI 24.2 - 36.0) vs. 36.2% (95%CI 34.1 - 38.3), 41.1% (95% CI 34.4 - 47.8) and 37.3% (95% CI 30.2 - 44.5) for females. Median relative survival for cases from metropolitan and non-metropolitan counties were 31 months and 31 months respectively. Five-year relative survivals were 35.1% (95% CI 33.7-36.5) and 32.6% (95% CI 29.1-36.0) for metropolitan and non-metropolitan counties MDS cases respectively. Conclusion The incidence of MDS was higher in males compared to females with the highest rate in white males. Survival rates were similar in both sexes. No significant difference in survival rates were seen among the racial groups. No significant difference in the median survival and five-year relative survival rates were noticed between metropolitan and non-metropolitan groups. Disclosures: No relevant conflicts of interest to declare.

Significant Recent Declines In Adult Leukemia Incidence Rates In the United States

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 873-873
Author(s):  
Julie A Ross ◽  
Kimberly J Johnson ◽  
James R Cerhan ◽  
Cindy K Blair ◽  
John T Soler ◽  
...  
Keyword(s):  
United States ◽  
Race And Ethnicity ◽  
Conflicts Of Interest ◽  
Statistical Significance ◽  
The United States ◽  
Incidence Rates ◽  
Years Of Life Lost ◽  
Newly Diagnosed ◽  
Incidence Trends ◽  
Time Period

Abstract Abstract 873 Each year in the United States, approximately 45,000 individuals are newly diagnosed with leukemia and 22,000 will die of the disease. Due to this poor survival, leukemia ranks fifth in person years of life lost among specific cancers. Little is known about causes, although exposure to solvents, radiation, pesticides and, to a modest extent, cigarette smoke has been implicated for some subtypes. The last comprehensive report of leukemia trends covered the period 1973–1998 [Xie Y et al, Cancer 2003]. Evaluation of recent leukemia incidence trends could provide important new etiologic insights. Using Surveillance, Epidemiology and End Results (SEER) Program data, we analyzed leukemia incidence trends in U.S. adults (≥ 20 years of age) by age, leukemia subtype (acute myeloid (AML), acute lymphoid (ALL), chronic myeloid (CML), chronic lymphoid (CLL)) sex, race, and ethnicity for the period 1987–2007. Frequencies, age-adjusted incidence rates (IR, per million), and trends were calculated along with annual percent change (APC) and corresponding 95% confidence intervals (CI). Joinpoint analyses were used to detect any significant directional changes in IRs over the period. Of 43,970 newly diagnosed cases identified, IRs increased with age and were consistently higher in males than females for all four subtypes. The highest IRs occurred for CLL (54.4), followed by AML (38.3), CML (20.6) and ALL (7.0). With regard to trends, IRs for CLL (APC -0.5; CI: -0.9, -0.1) and CML (APC -1.2; CI: -1.6, -0.8) declined over the time period; declines were observed in males and females, and by race and ethnicity. Male(M):Female(F) IR ratios remained relatively constant at approximately 2.0 and 1.7, respectively. For ALL, IRs decreased in males (APC -0.9; CI: -1.9, 0.2) but slightly increased in females (APC 0.4; CI: -1.0, 1.7), which was most notable in Hispanics (APC 4.0; CI: 1.2, 6.8). In contrast to CML and CLL, the overall M:F rate ratio for ALL decreased, although it did not reach statistical significance (p=0.08). For AML, IRs increased significantly for males (APC 1.0; CI: 0.3,1.6) and females (APC 1.7; CI: 0.7, 2.7) from 1987–2000 and 1987–2001, respectively. However, since then, AML IRs for males have been significantly decreasing by 4.2% per year (CI: -6.4, -2.1), while IRs for females have been decreasing by 1.6% per year (CI: -4.1, 0.9). Across the entire time period 1987–2007, there was a statistically significant negative trend (p=0.002) in the M:F IR ratio for AML. Decreasing IRs across many leukemias since 1987 are unlikely to reflect changes in screening or diagnostic coding practices. Instead, these observations may reflect temporal changes in etiologically relevant environmental exposures. Of note, the prevalence of cigarette smoking in the population has decreased and occupational safety practices (e.g., reducing solvent/radiation/pesticide exposure) have improved over the last several decades, which could contribute to the gradual decreases in some IRs observed. In contrast, the rapid and significant decrease noted for AML since 2000, especially following a significant increase, was striking and deserved additional scrutiny. We further consulted with our cancer registry colleagues to determine whether the introduction of myelodysplastic syndrome (MDS) as a new malignancy in SEER in 2001 could be influencing recent AML trends given the (apparently) coincidental overlap in time periods. Of note, approximately one third of MDS patients subsequently develop AML. We learned that AML following an MDS diagnosis from 2001–2009 was not reportable to SEER and therefore not counted. We are not aware that this has been documented in the literature. However, beginning for 2010 diagnoses, SEER changed this practice such that AML following MDS will be captured as a second malignancy. Based on these changes in AML surveillance, it will especially be important to monitor future trends for this malignancy. Overall, this study demonstrates the value of in-depth analyses of SEER cancer IRs and trends; analyses may reveal patterns of clinical and/or etiological importance, or, in the instance of AML, unpublished coding rule changes. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Disparities of birth cohort effects on pancreatic cancer incidence between the United States and urban China

ESMO Open ◽  
2021 ◽  
Vol 6 (5) ◽  
pp. 100240
Author(s):  
S. Yang ◽  
K.W. Yeoh ◽  
M.C.-S. Wong ◽  
O.W.-K. Mang ◽  
L.A. Tse
Keyword(s):  
United States ◽  
Pancreatic Cancer ◽  
Birth Cohort ◽  
Cancer Incidence ◽  
The United States ◽  
Urban China ◽  
Cohort Effects

scholarly journals Real-World Utilization of Oral Anticancer Agents Costs in Older Adults with Metastatic Renal Cell Carcinoma in the United States

Kidney Cancer ◽  
2021 ◽  
pp. 1-13
Author(s):  
Lauren E. Wilson ◽  
Lisa Spees ◽  
Jessica Pritchard ◽  
Melissa A. Greiner ◽  
Charles D. Scales ◽  
...  
Keyword(s):  
United States ◽  
Anticancer Agents ◽  
Patient Characteristics ◽  
The United States ◽  
Socioeconomic Indicators ◽  
Economic Implications ◽  
Southern Us ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Oral Anticancer Agents

Background: Substantial racial and socioeconomic disparities in metastatic RCC (mRCC) have persisted following the introduction of targeted oral anticancer agents (OAAs). The relationship between patient characteristics and OAA access and costs that may underlie persistent disparities in mRCC outcomes have not been examined in a nationally representative patient population. Methods: Retrospective SEER-Medicare analysis of patients diagnosed with mRCC between 2007–2015 over age 65 with Medicare part D prescription drug coverage. Associations between patient characteristics, OAA receipt, and associated costs were analyzed in the 12 months following mRCC diagnosis and adjusted to 2015 dollars. Results: 2,792 patients met inclusion criteria, of which 32.4%received an OAA. Most patients received sunitinib (57%) or pazopanib (28%) as their first oral therapy. Receipt of OAA did not differ by race/ethnicity or socioeconomic indicators. Patients of advanced age (>  80 years), unmarried patients, and patients residing in the Southern US were less likely to receive OAAs. The mean inflation-adjusted 30-day cost to Medicare of a patient’s first OAA prescription nearly doubled from $3864 in 2007 to $7482 in 2015, while patient out-of-pocket cost decreased from $2409 to $1477. Conclusion: Race, ethnicity, and socioeconomic status were not associated with decreased OAA receipt in patients with mRCC; however, residing in the Southern United States was, as was marital status. Surprisingly, the cost to Medicare of an initial OAA prescription nearly doubled from 2007 to 2015, while patient out-of-pocket costs decreased substantially. Shifts in OAA costs may have significant economic implications in the era of personalized medicine.

Sign in / Sign up

Export Citation Format

Share Document