COVID-19 in Africa: an ovarian victory?

AbstractCoronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) mainly attacks the respiratory system and is characterized by pneumonia, cytokine storm, coagulation disorders and severe immune downregulation. Although public health experts predicted worst outcomes in Africa, the incidence, hospitalization and mortality rates have been lower in Africa compared to other continents. Interestingly, lower incidence and mortality rates have been observed in women from Africa compared to their cohorts from other continents. Also, in the US non-Hispanic Black females have lower COVID-19 and death rates compared to their white counterparts. It’s unclear why this significant difference exists; however, the ovarian function, genetics and immunological statuses could play a major role. Women of African descent have elevated levels of estrogen compared with Caucasians hence we anticipate that estrogen might offer some protection against the SARS-CoV-2 infections. The racial differences in lifestyle, age and inaccessibility to contraceptive usage might also play a role. Here, we provide insight on how the high levels of estrogen in African women might contribute to the lower cases and fatalities in Africa. Specifically, estrogen might offer protection against COVID-19 by suppressing hyper-production of cytokines, promoting anti-inflammatory cytokines, stimulating antibody production and suppressing endoplasmic reticulum (ER) stress. This will as well provide useful information on how future pandemics could be managed using Africa as a case study.

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Prostate Cancer Incidence and Mortality in Barbados, West Indies

Prostate Cancer ◽

10.1155/2011/565230 ◽

2011 ◽

Vol 2011 ◽

pp. 1-10 ◽

Cited By ~ 14

Author(s):

Anselm J. M. Hennis ◽

Ian R. Hambleton ◽

Suh-Yuh Wu ◽

Desiree H.-A. Skeete ◽

Barbara Nemesure ◽

...

Keyword(s):

Prostate Cancer ◽

African American ◽

Cancer Incidence ◽

West Indies ◽

African American Men ◽

Mortality Rates ◽

Prostate Cancer Incidence ◽

White American ◽

Incidence And Mortality ◽

The Us

We describe prostate cancer incidence and mortality in Barbados, West Indies. We ascertained all histologically confirmed cases of prostate cancer during the period July 2002 to December 2008 and reviewed each death registration citing prostate cancer over a 14-year period commencing January 1995. There were 1101 new cases for an incidence rate of 160.4 (95% Confidence Interval: 151.0–170.2) per 100,000 standardized to the US population. Comparable rates in African-American and White American men were 248.2 (95% CI: 246.0–250.5) and 158.0 (95% CI: 157.5–158.6) per 100,000, respectively. Prostate cancer mortality rates in Barbados ranged from 63.2 to 101.6 per 100,000, compared to 51.1 to 78.8 per 100,000 among African Americans. Prostate cancer risks are lower in Caribbean-origin populations than previously believed, while mortality rates appeared to be higher than reported in African-American men. Studies in Caribbean populations may assist understanding of disparities among African-origin populations with shared heredity.

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Racial disparities in comprehensive biomarker testing and clinical trial enrollment among patients with metastatic colorectal cancer (mCRC).

Journal of Clinical Oncology ◽

10.1200/jco.2020.39.28_suppl.125 ◽

2021 ◽

Vol 39 (28_suppl) ◽

pp. 125-125

Author(s):

Lisa M. Hess ◽

Debora S. Bruno ◽

Xiaohong Li ◽

Eric Wen Su ◽

Monaliben Patel

Keyword(s):

Clinical Trial ◽

Racial Disparities ◽

Racial Differences ◽

Significant Relationship ◽

Trial Participation ◽

Regression Analyses ◽

Significant Difference ◽

The Us ◽

Biomarker Testing ◽

Clinical Trial Enrollment

125 Background: Racial disparities may exist at many levels in the health care system; in oncology, yet little is known about racial disparities in biomarker testing and clinical trial enrollment among patients with mCRC. This study was designed to explore racial differences in comprehensive biomarker testing and clinical trial enrollment in the US using a large real-world database. Methods: This retrospective observational study utilized the Flatiron Health electronic health records database, which includes longitudinal data from patients diagnosed with mCRC. Patients with mCRC were eligible for this study if they had evidence of systemic therapy from 1/1/2017 through 10/30/2020 and were alive for at least 120 days after metastatic diagnosis. Unadjusted analyses summarized differences in biomarker testing and clinical trial enrollment between White and Black race, adjusted regression analyses were conducted using all baseline variables as covariates. These data are de-identified and are not considered human subjects research in accordance with the US Code of Federal Regulations (45 CFR Part 46). Results: A total of 7,879 patients were eligible: 4,803 (61.0%) were White and 838 (10.6%) were Black. Comprehensive testing by next-generation sequencing (NGS) was received by 51.6% and 41.8% of patients who were White and Black, respectively (p < 0.0001). There was no significant difference in clinical trial participation across all lines of therapy (2.9%, White and 2.9% Black). There was a statistically significant relationship between NGS-based testing and clinical trial enrollment (p < 0.0001), however, race was not identified a moderating factor in this relationship in adjusted regression analyses. The receipt of molecularly-targeted therapy was comparable between both races (11.9% and 9.7% for White and Black, respectively; p = 0.06). Patients received FOLFOX+bevacizumab most commonly in the first line (34.3% White; 40.5% Black), all other regimens were within 2 percentage points between racial groups. Targeted agents were each used by less than 7.4% of the study population. Conclusions: The use of NGS-based testing is significantly different by race in this database. The significant relationship between NGS testing and clinical trial enrollment at any time in the database did not appear to be moderated by race; however, descriptive analyses suggest that the ongoing analyses by line of therapy and considering timing of testing may better quantify these relationships. These data may not be generalizable to the entire US population as they are obtained from a single database that is limited to practices using this EHR system.

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Surveillance of the Incidence and Mortality of Oral and Pharyngeal, Esophageal, and Lung Cancer in Nevada: Potential Implications of the Nevada Indoor Clean Air Act

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157966 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7966

Author(s):

Kevin Foote ◽

David Foote ◽

Karl Kingsley

Keyword(s):

Public Health ◽

Lung Cancer ◽

Oral Cancer ◽

Cancer Incidence ◽

Mortality Rates ◽

Lung Cancer Incidence ◽

Annual Percent Change ◽

Smoking Restrictions ◽

Incidence And Mortality ◽

The Us

Reviews of national and state-specific cancer registries have revealed differences in rates of oral, esophageal, and lung cancer incidence and mortality that have implications for public health research and policy. Many significant associations between these types of cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans—including the Nevada Clean Indoor Air Act (NCIAA) of 2006 (and subsequent modification in 2011). Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of oral and pharyngeal, esophageal, and lung cancer incidence and mortality in Nevada. Methods: Cancer incidence and mortality rate data were obtained from the National Cancer Institute (NCI) Division of Cancer Control and Population Sciences (DCCPS) Surveillance, Epidemiology and End Results (SEER) program. Most recently available rate changes in cancer incidence and mortality for Nevada included the years 2012–2016 and are age-adjusted to the year 2000 standard US population. This analysis revealed that the overall rates of incidence and mortality from these types of cancer in Nevada differs from that observed in the overall US population. For example, although the incidence rate of oral cancer is decreasing in the US overall (0.9%), it is stable in Nevada (0.0%). However, the incidence and mortality rates from esophageal cancer are also decreasing in the US (−1.1%, −1.2%, respectively), and are declining more rapidly in Nevada (−1.5%, −1.9%, respectively). Similarly, the incidence and mortality rates from lung are cancer are declining in the US (−2.5%, −2.4%, respectively) and are also declining more rapidly in Nevada (−3.2%, −3.1%, respectively). Analysis of previous epidemiologic data from Nevada (1999–2003) revealed the highest annual percent change (APC) in oral cancer incidence in the US was observed in Nevada (+4.6%), which corresponded with the highest APC in oral cancer mortality (+4.6%). Subsequent studies regarding reduced rates of cigarette use due to smoking restrictions and bans have suggested that follow up studies may reveal changes in the incidence and mortality rates of oral and other related cancers. This study analysis revealed that oral cancer incidence rates are no longer increasing in Nevada and that mortality rates have started to decline, although not as rapidly as the overall national rates. However, rapid decreases in both the incidence and mortality from esophageal and lung cancer were observed in Nevada, which strongly suggest the corresponding changes in oral cancer may be part of a larger epidemiologic shift resulting from improved public health policies that include indoor smoking restrictions and bans.

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Cancer incidence and mortality in the Caribbean

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.21110 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 21110-21110

Author(s):

A. A. Phillips ◽

J. S. Jacobson ◽

C. Magai ◽

N. Consedine ◽

N. C. Horowicz-Mehler ◽

...

Keyword(s):

Cancer Incidence ◽

Large Bowel ◽

The United States ◽

Mortality Rates ◽

Caribbean Region ◽

International Agency ◽

Incidence And Mortality ◽

Liver Cancers ◽

The Us ◽

The Caribbean

21110 Background: Nearly 10% of immigrants to the United States come from the Caribbean region. In this paper, we analyzed incidence and mortality rates of the major cancers in the Bahamas, Barbados, Cuba, the Dominican Republic, Haiti, Jamaica, Puerto Rico, and Trinidad and Tobago, and compared them with US patterns. Methods: We obtained age-standardized, sex-specific cancer incidence and mortality rates for cancers of the bladder, breast, cervix, esophagus, large bowel, liver, lung, pancreas, prostate, and stomach for eight Caribbean countries and the US from the GLOBOCAN program of the International Agency for Research in Cancer (IARC) and for the US population from the Surveillance, Epidemiology, and End Results (SEER) Program of the NCI. Results: GLOBOCAN incidence and mortality rates for the overall US were lower than but correlated with overall SEER rates. Based on GLOBOCAN data, the incidence and mortality rates of cancers of the breast, prostate, large bowel, and lung, and, among males, bladder cancer were lower in the Caribbean countries than the US. Caribbean countries had higher rates of cancers of the cervix, esophagus, liver, and stomach. Haiti had the highest incidence and mortality rates of cervix and liver cancers. Jamaica and Haiti had the highest rates of stomach cancer. Conclusions: Cancer incidence and mortality in the Caribbean generally follow known patterns of association with economic development, infectious agents, and racial/ethnic origin. Studying these patterns and how immigration changes them may yield clues to cancer etiology. A better understanding of cancer incidence and mortality rates may help health policymakers to implement state-of-the-art treatment and preventive services for people of Caribbean descent both in their native countries and in immigrant communities in the US. [Table: see text] No significant financial relationships to disclose.

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Higher incidence and mortality rates of cervical cancer in African-American women in Louisiana.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e17522 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e17522-e17522

Author(s):

Genevieve Folse Maronge ◽

Xiao-cheng Wu ◽

Vivien Chen ◽

Xiangrong Li ◽

Brian C. Boulmay ◽

...

Keyword(s):

United States ◽

Cervical Cancer ◽

African American Women ◽

Hpv Vaccine ◽

White Women ◽

The United States ◽

Mortality Rates ◽

Hospital System ◽

Incidence And Mortality ◽

The Us

e17522 Background: Cervical cancer [CC] incidence in the United States has decreased over the last thirty years in black and white Americans, however it is recognized that black women [BW] have higher incidence and mortality rates than white women [WW]. We evaluated race-specific incidence of CC, mortality rates of CC, and HPV vaccine usage rates in Louisiana [LA] during the last decade, the state with the second highest proportion of black Americans in the United States [US]. Methods: Data from Surveillance, Epidemiology, and End Results (SEER) registries were analyzed for trends in incidence and mortality rate [MR] in BW and WW in LA and the US. SEER 13 and SEER 18 data were used and standardized to the 2000 US population to estimate annual age-adjusted incidence and mortality rates. Results: The incidence of CC in WW in LA was 8.2 per 100,000 from 2006 to 2009, and 7.9 per 100,000 in WW in US. The incidence in BW in LA was 13.3 per 100,000, as compared to the US at 9.7 per 100,000, a 36% higher incidence in BW. The MR in WW in LA and the US was 2.4 and 2.2 per 100,000. The MR for BW in LA was 5.8 per 100,000 and the US was 4.3 per 100,000, a 37% higher incidence in BW. WW in LA and the US showed a peak in incidence between the ages of 35 and 45 from 2006 to 2009. The incidence in BW in LA peaked at 37.1 per 100,000 at age 85 and the incidence in BW in the US peaked at 25.6 per 100,000 at age 85. HPV vaccination rates for LA females ages 13-15 in 2008 and 2009 were 16.1% and 35.4%. Conclusions: BW in LA were twice as likely to be diagnosed with CC than WW with a higher MR. Though the incidence rate of CC is decreasing in WW and BW in the US and in WW in LA, it is increasing in BW in LA and continues to trend up throughout life in BW compared to WW. The high incidence of CC in BW in LA highlights the need to improve utilization of the HPV vaccine. A screening and treatment program targeting CC was implemented within the last decade in the LA public hospital system with the goal of reducing CC incidence and mortality.

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Fifteen-year trends and differences in mortality rates across sex, age, and race/ethnicity in patients with brainstem tumors

Neuro-Oncology Advances ◽

10.1093/noajnl/vdab137 ◽

2021 ◽

Author(s):

Yusuke Tomita ◽

Yoshihiro Tanaka ◽

Nozomu Takata ◽

Elizabeth A Hibler ◽

Rintaro Hashizume ◽

...

Keyword(s):

Racial Differences ◽

Age Groups ◽

Mortality Rates ◽

Older Age ◽

Age Group ◽

Younger Age ◽

The Us ◽

Brainstem Tumors ◽

Race Ethnicity ◽

Adjusted Incidence

Abstract Background Localization of tumors to the brainstem carries a poor prognosis, however, risk factors are poorly understood. We examined secular trends in mortality from brainstem tumors in the US by age, sex, and race/ethnicity. Methods We extracted age-adjusted incidence-based mortality rates of brainstem tumors from the Surveillance, Epidemiology and End Results (SEER) database between 2004 and 2018. Trends in age-adjusted mortality rate (AAMR) were compared by sex and race/ethnicity among the younger age group (0-14 years) and the older age group (>15 years) respectively. Average AAMRs in each 5-year age group were compared by sex. Results This study included 2,039 brainstem tumor-related deaths between 2004 and 2018. Trends in AAMRs were constant during the study period in both age groups, with 3 times higher AAMR in the younger age group compared to the older age group. Males had a significantly higher AAMR in the older age group, while no racial differences were observed. Intriguingly, AAMRs peaked in patients 5-9 years of age (0.57 per 100,000) and in patients 80-84 years of age (0.31 per 100,000), with lower rates among middle-aged individuals. Among 5-9 years of age, the average AAMR for females was significantly higher than that of males (p=0.017), whereas the reverse trend was seen among those 50-79 years of age. Conclusions Overall trends in AAMRs for brainstem tumors were constant during the study period with significant differences by age and sex. Identifying the biological mechanisms of demographic differences in AAMR may help understand this fatal pathology.

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Racial differences in prostate cancer incidence and mortality.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e15119 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e15119-e15119

Author(s):

Marc Bjurlin ◽

Patrick Guinan ◽

Kevin Christensen ◽

Marvin Rubenstein

Keyword(s):

Prostate Cancer ◽

Racial Differences ◽

Cancer Incidence ◽

Mortality Rates ◽

Seer Database ◽

Prostate Cancer Incidence ◽

Incidence And Mortality ◽

The U.S

e15119 Background: Prostate cancer is the second leading cause of male cancer deaths in the U.S. There are significant racial differences in prostate cancer incidence and mortality. Methods: The SEER Database for 2008 was analysed for designated areas: Connecticut, Detroit, and Hawaii, assuming that these areas are surrogates for whites, blacks, and Asians, respectively. Results: Incidence and mortality (see Table). Conclusions: Assuming that the geographic SEER areas (Conn, Det, Ha) are surrogates for whites, blacks, and Oriental populations, we conclude that the incidence and mortality rates for blacks are higher than those for whites and Orientals. [Table: see text]

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Gender disparities in anal cancer incidence and mortality: A long-term US population-based analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e16059 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e16059-e16059

Author(s):

Firas Baidoun ◽

Anas M Saad ◽

Mohamed Gad ◽

Mohammad Maysara Asfari ◽

Muhammad Talal Sarmini ◽

...

Keyword(s):

Anal Cancer ◽

Cancer Incidence ◽

Cancer Mortality ◽

Mortality Rates ◽

Mortality Trend ◽

Annual Percent Change ◽

Gastrointestinal Malignancies ◽

Incidence And Mortality ◽

The Us ◽

Males And Females

e16059 Background: Anal cancer is an uncommon malignancy accounting for less than 3% of gastrointestinal malignancies in the US. In this large database study, we aimed to re-evaluate the difference in the incidence and mortality trend in both genders. Methods: We used SEER 18 database to study anal cancer cases in the US during 2000-2016. Incidence and mortality rates of anal cancer were calculated by gender and were expressed by 1,000,000 person-years. Annual percent change (APC) was calculated using join point regression software. Results: We reviewed 25,418 patients with anal cancer, of which 61.4% were females. Incidence of anal cancers was 14.375 and 19.427 per 1,000,000 person-years, in males and females, respectively. Incidence rates of anal cancer significantly increased over the study period, but this increase was sharper in females (APC = 2.220%, 95%CI [1.924-2.517], P < .001) when compared to males (APC = 0.915%, 95%CI [0.303-1.531], P = .006). Mortality rates from anal cancer over the study period were 7.425 and 7.532 per 1,000,000 person-years, in males and females, respectively. Overall anal cancer mortality rates did not change between 2000-2009 but started to decrease starting from 2010 and this decrease became sharpest between 2014-2016; APC = -44.905%, 95%CI [-57.572- -28.457], P = .001). Mortality rates followed the same trend in both genders. Conclusions: Anal cancer incidence is increasing with significant increase in the incidence trend is noticed in females compared to males which is a change from the previous trend that was seen from 1973-2000. On the other hand, anal cancer mortality has started to decrease for the first time starting from 2010 with no difference in the mortality trend between males and females. This improvement in mortality rate can be explained by the improvement in early detection rate and possibly improvement in the treatment approach for these high-risk patients.

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Trends in the incidence and mortality of oral cancer in Nevada (Preprint)

10.2196/preprints.19675 ◽

2020 ◽

Author(s):

Kevin Foote ◽

Karl Kingsley

Keyword(s):

Public Health ◽

Oral Cancer ◽

Cancer Incidence ◽

Cancer Control ◽

Cancer Registries ◽

Public Health Research ◽

Chi Square ◽

Incidence And Mortality ◽

The Us ◽

Chi Square Analysis

BACKGROUND Reviews of national and state-specific cancer registries have revealed differences in rates of oral cancer incidence and mortality that have implications for public health research and policy. Many significant associations between head and neck (oral) cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans – including the Nevada Clean Indoor Act of 2006 (and subsequent modification in 2011). OBJECTIVE Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of oral cancer incidence and mortality in Nevada. METHODS Cancer incidence and mortality rate data were obtained from the National Cancer Institute (NCI) Division of Cancer Control and Population Sciences (DCCPS) Surveillance, Epidemiology and End Results (SEER) program. Most recently available rate changes in cancer incidence and mortality for Nevada included the years 2012 – 2016 and are age-adjusted to the year 2000 standard US population. Comparisons of any differences between Nevada and the overall US population were evaluated using Chi square analysis. RESULTS This analysis revealed that the overall rates of incidence and mortality from oral cancer in Nevada differs from that observed in the overall US population. For example, although the incidence of oral cancer among Caucasians is increasing in Nevada and the US overall, it is increasing at nearly twice that rate in Nevada, P=0.0002. In addition, although oral cancer incidence among Minorities in the US is declining, it is increasing in Nevada , P=0.0001. Analysis of reported mortality causes revealed that mortality from oral cancer increased in the US overall but declined in Nevada during the same period (2012-2016). More specifically, mortality among both Males and Females in the US is increasing, but is declining in Nevada, P=0.0027. CONCLUSIONS Analysis of the epidemiologic data from Nevada compared with the overall US revealed significant differences in rates of oral cancer incidence and mortality. More specifically, oral cancer incidence increased in Nevada between 2012-2016 among all groups analyzed (Males, Females, White, Minority), while decreases were observed nationally among Females and Minorities. Although mortality in Nevada decreased over this same time period (in contrast to the national trends), the lag time between diagnosis (incidence) and mortality suggests that these trends will change in the near future. CLINICALTRIAL Not applicable

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Bioelectric Effect of a Microcurrent Toothbrush on Plaque Removal

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168255 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8255

Author(s):

Ji-Hyun Lee ◽

Jin-Hee Ha

Keyword(s):

Bacterial Flora ◽

Gingival Index ◽

Direct Electric Current ◽

Plaque Removal ◽

Bioelectric Effect ◽

Biofilm Removal ◽

Significant Difference ◽

The Us ◽

Before And After ◽

Previous State

This study evaluated the effectiveness of a microcurrent toothbrush (approved by the US Food and Drug Administration [FDA]), which employs a superimposed alternating and direct electric current, named as a Proxywave® technology, similar to the intensity of the biocurrent, in plaque removal and reducing gingivitis by biofilm removal through the bioelectric effect. This study enrolled 40 volunteers with gingivitis. Dental observations were made every two weeks, before and after the use of each toothbrush. We randomly assigned participants into two groups: one group used the Proxywave® toothbrush (PB) for two weeks followed by the control toothbrush (CB) for two weeks, while the other group used the CB for two weeks followed by the PB. The participants had a two-week washout period. If the toothbrush used earlier has had an effect on the bacterial flora in the oral cavity, this is to remove this effect and return it to its previous state. During each dental visit, we recorded plaque index (PI) and gingival index (GI) scores. The PI and GI scores were significantly lower in both the PB and the CB (p < 0.05). Considering the PI, there was no significant difference between the toothbrushes on all the surfaces. Considering the GI, the PB showed a significant decrease in the interproximal surface, compared to the CB (p < 0.05). The PB showed a significant decrease in the interproximal GI and had a beneficial effect in the interproximal area where the bristles could not reach. No adverse events were observed in the participants during the clinical trial. The microcurrent toothbrush is a device that can be safely used for plaque removal.

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