Esophageal cancer incidence gender disparity.

1573 Background: Over the past 30 years, esophageal cancer incidence has been increasing more rapidly than any other solid neoplasm in the Western world. Globally, there is a large male predominance in both esophageal squamous and adenocarcinoma. The reasons for this gender difference and the possible role of estrogen are unclear. The objective of this study is to determine if estrogen exposure is consistent with the male predominance observed in esophageal cancer incidence. Methods: A database assessment of esophageal cancer incidence rates (age-adjusted) from 1975 to 2008 was conducted in the National SEER 9 Database and the Maryland Cancer Registry. Rates by gender and age were calculated. Gender-specific incidence rate ratios were compared across age groups. Annual percentage change (APC) was compared for each gender-age group. Results: In both national and state, male and female, adeno and squamous cell histologies, incidence rates increase with patient age. SEER data trends revealed the 50-64 aged female cohort as the only gender-age cohort APC decreasing between 1975-2008. Furthermore, a significant increase in incidence for females is observed in the 65+ age groups; whereas among males, the rates are rising in all age groups. Conclusions: Using age as a proxy for estrogen exposure, our findings suggest a hormonal component in the declining male: female esophageal cancer incidence rate ratios with increasing age and confirm gender differences in incidence long observed in esophageal cancer. Histological features may be predictive of a lower rate ratio. (Bodelon et al. 2011) Estrogen exposure may play a protective role in esophageal cancer which dissipates with time after age 60-69. Our data suggest possible future roles of estrogen as a chemopreventive agent in esophageal cancer (Barone et al. 2011). [Table: see text] [Table: see text]

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Esophageal cancer gender disparity.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.30_suppl.47 ◽

2012 ◽

Vol 30 (30_suppl) ◽

pp. 47-47 ◽

Cited By ~ 2

Author(s):

Luckson Noe Mathieu ◽

Norma Kanarek ◽

Craig Hooker ◽

Charles M. Rudin ◽

Malcolm Brock

Keyword(s):

Esophageal Cancer ◽

Incidence Rate ◽

Cancer Incidence ◽

Hormonal Therapy ◽

Protective Role ◽

Age Group ◽

Male Predominance ◽

Estrogen Exposure ◽

Post Menopausal

47 Background: Over the past thirty years, esophageal cancer (EC) incidence has been increasing more rapidly than any other solid neoplasm in the Western world. Globally, there is a large male predominance in both esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). The reasons for this gender difference and the possible role of estrogen are unclear. We conducted an analytical epidemiological study to determine if estrogen exposure explains the male predominance in observed esophageal cancer incidence. Methods: We evaluated the SEER cancer incidence and trends from 1975 to 2008 using SEER Stat to calculate the annual percentage change (APC) in each ten-year age group and in EAC and ESCC by gender. Results: Male predominance in incidence rates of EC was most evident in the younger group and those with EAC histology. The rate of increase for EAC incidence in post menopausal females is greater than in any other demographic category. This increasing incidence rate in the post menopausal female was also observed in the ESCC, but to a lesser extent. The APC was negative (-1.5) between 1975-2008 only in the 50-64 age female group. The negative APC in the female 50-64 years age group may be due to the increased use of exogenous hormonal therapy since 1975 for this age group. Interestingly, the APC was positive (increasing) in the 65+ age females. Conclusions: Using age as a proxy for estrogen exposure, our findings suggest a hormonal reason for the observed age-related, declining male to female EC incidence rate ratios. It also confirms gender differences in incidence long observed in EC and suggests that estrogen may serve as a preventative agent against EC. Moreover, this protective role of estrogen may dissipate with time if post menopausal estrogen use is discontinued. We have initiated a subset analysis of the nine individual SEER sites’ database to confirm the above findings by location and plan to further assess the relationship of both endogenous and exogenous estrogen via hormonal therapy use in EC incidence in the Women’s Health Initiative cohort. Our epidemiological observation of gender-age differences warrants translation into a molecular study with the use of sophisticated biomarkers to establish the seemingly protective role of estrogen in esophageal cancer.

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Sex differences in campylobacteriosis incidence rates at different ages - a seven country, multi-year, meta-analysis. A potential mechanism for the infection.

10.21203/rs.2.19298/v2 ◽

2020 ◽

Author(s):

Manfred S Green ◽

Naama Schwartz ◽

Victoria Peer

Keyword(s):

Vaccine Development ◽

Meta Analysis ◽

Age Groups ◽

Incidence Rates ◽

Age Group ◽

Male Predominance ◽

Time Period ◽

Meta Regression ◽

Time Periods ◽

Rate Ratios

Abstract Background. There is evidence of an excess of males in the incidence rates of campylobacteriois. The objectives of this study were to determine whether these observations differ between age groups and are consistent over different countries and during different time periods. Methods. We obtained data on incidence rates of campylobacteriosis by sex and age group over a period of 11-26 years from seven countries. Male to female incidence rate ratios (IRR) were computed by age group, country and time period. For each age group, we used meta-analytic methods to combine the IRRs. Sensitivity analysis was used to test whether the results are robust to differences between countries and time periods. Meta-regression was conducted to estimate the different effects of age, country, and time period on the IRR. Results. In the age groups <1, 1-4, 5-9, 10-14, 15-44, 45-64 and 65+ years old, the pooled IRRs (with 95% CI) were 1.31 (1.26-1.37), 1.34 (1.31-1.37), 1.35 (1.32-1.38), 1.73 (1.68-1.79), 1.10 (1.08-1.12), 1.19(1.17-1.21) and 1.27 (1.24-1.30), respectively. For each age group, the excess campylobacteriosis incidence rates in males differed at different age groups. However, despite some quantitative differences between countries, the excess was consistently present over long time-periods. In meta-regression analysis, age group was responsible for almost all the variation in the IRRs. Conclusions. The male predominance in campylobacteriosis incidence rates starts in infancy. This suggests that this is due, at least in part, to physiological or genetic differences and not just behavioural factors. These findings can provide clues to the mechanisms of the infection and could lead to more targeted treatments and vaccine development.

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The campylobacteriosis conundrum – examining the incidence of infection with Campylobacter sp. in Australia, 1998–2013

Epidemiology and Infection ◽

10.1017/s0950268816002909 ◽

2016 ◽

Vol 145 (4) ◽

pp. 839-847 ◽

Cited By ~ 11

Author(s):

C. R. M. MOFFATT ◽

K. GLASS ◽

R. STAFFORD ◽

C. D'ESTE ◽

M. D. KIRK

Keyword(s):

Incidence Rate ◽

Negative Binomial ◽

Age Groups ◽

Negative Binomial Regression ◽

Incidence Rates ◽

Age Group ◽

Disease Notification ◽

Significant Public Health ◽

Rate Ratios ◽

Over Time

SUMMARYCampylobacter sp. are a globally significant cause of gastroenteritis. Although rates of infection in Australia are among the highest in the industrialized world, studies describing campylobacteriosis incidence in Australia are lacking. Using national disease notification data between 1998 and 2013 we examined Campylobacter infections by gender, age group, season and state and territory. Negative binomial regression was used to estimate incidence rate ratios (IRRs), including trends by age group over time, with post-estimation commands used to obtain adjusted incidence rates. The incidence rate for males was significantly higher than for females [IRR 1·20, 95% confidence interval (CI) 1·18–1·21], while a distinct seasonality was demonstrated with higher rates in both spring (IRR 1·18, 95% CI 1·16–1·20) and summer (IRR 1·17, 95% CI 1·16–1·19). Examination of trends in age-specific incidence over time showed declines in incidence in those aged <40 years combined with contemporaneous increases in older age groups, notably those aged 70–79 years (IRR 1998–2013: 1·75, 95% CI 1·63–1·88). While crude rates continue to be highest in children, our findings suggest the age structure for campylobacteriosis in Australia is changing, carrying significant public health implications for older Australians.

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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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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.

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Injury Incidence Across the Menstrual Cycle in International Footballers

Frontiers in Sports and Active Living ◽

10.3389/fspor.2021.616999 ◽

2021 ◽

Vol 3 ◽

Author(s):

Dan Martin ◽

Kate Timmins ◽

Charlotte Cowie ◽

Jon Alty ◽

Ritan Mehta ◽

...

Keyword(s):

Menstrual Cycle ◽

Incidence Rate ◽

Luteal Phase ◽

Incidence Rates ◽

Follicular Phase ◽

Tendon Injuries ◽

Cycle Phase ◽

Injury Incidence ◽

Rate Ratios ◽

Late Follicular Phase

Objectives: This study aimed to assess how menstrual cycle phase and extended menstrual cycle length influence the incidence of injuries in international footballers.Methods: Over a 4-year period, injuries from England international footballers at training camps or matches were recorded, alongside self-reported information on menstrual cycle characteristics at the point of injury. Injuries in eumenorrheic players were categorized into early follicular, late follicular, or luteal phase. Frequencies were also compared between injuries recorded during the typical cycle and those that occurred after the cycle would be expected to have finished. Injury incidence rates (per 1,000 person days) and injury incidence rate ratios were calculated for each phase for all injuries and injuries stratified by type.Results: One hundred fifty-six injuries from 113 players were eligible for analysis. Injury incidence rates per 1,000 person-days were 31.9 in the follicular, 46.8 in the late follicular, and 35.4 in the luteal phase, resulting in injury incidence rate ratios of 1.47 (Late follicular:Follicular), 1.11 (Luteal:Follicular), and 0.76 (Luteal:Late follicular). Injury incident rate ratios showed that muscle and tendon injury rates were 88% greater in the late follicular phase compared to the follicular phase, with muscle rupture/tear/strain/cramps and tendon injuries/ruptures occurring over twice as often during the late follicular phase compared to other phases 20% of injuries were reported as occurring when athletes were “overdue” menses.Conclusion: Muscle and tendon injuries occurred almost twice as often in the late follicular phase compared to the early follicular or luteal phase. Injury risk may be elevated in typically eumenorrheic women in the days after their next menstruation was expected to start.

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Descriptive Epidemiology of Injuries in Professional Ultimate Frisbee Athletes

Journal of Athletic Training ◽

10.4085/1062-6050-269-18 ◽

2020 ◽

Vol 55 (2) ◽

pp. 195-204 ◽

Cited By ~ 2

Author(s):

Matthew C. Hess ◽

David I. Swedler ◽

Christine S. Collins ◽

Brent A. Ponce ◽

Eugene W. Brabston

Keyword(s):

Incidence Rate ◽

Epidemiologic Study ◽

Incidence Rates ◽

Thigh Muscle ◽

Surveillance Program ◽

Injury Incidence ◽

Descriptive Epidemiology ◽

Injury Rates ◽

Ultimate Frisbee ◽

Rate Ratios

Context Injuries in professional ultimate Frisbee (ultimate) athletes have never been described. Objective To determine injury rates, profiles, and associated factors using the first injury-surveillance program for professional ultimate. Design Descriptive epidemiology study. Setting American Ultimate Disc League professional ultimate teams during the 2017 season. Patients or Other Participants Sixteen all-male teams. Main Outcome Measure(s) Injury incidence rates (IRs) were calculated as injuries per 1000 athlete-exposures (AEs). Incidence rate ratios were determined to compare IRs with 95% confidence intervals, which were used to calculate differences. Results We observed 299 injuries over 8963 AEs for a total IR of 33.36 per 1000 AEs. Most injuries affected the lower extremity (72%). The most common injuries were thigh-muscle strains (12.7%) and ankle-ligament sprains (11.4%). Running was the most frequent injury mechanism (32%). Twenty-nine percent of injuries involved collisions; however, the concussion rate was low (IR = 0.22 per 1000 AEs). Injuries were more likely to occur during competition and in the second half of games. An artificial turf playing surface did not affect overall injury rates (Mantel-Haenszel incidence rate ratio = 1.28; 95% confidence interval = 0.99, 1.67). Conclusions To our knowledge, this is the first epidemiologic study of professional ultimate injuries. Injury rates were comparable with those of similar collegiate- and professional-level sports.

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Abstract A113: Regional variations in esophageal cancer incidence rates by census region in the United States, 1999-2008

Cancer Prevention Research ◽

10.1158/1940-6207.prev-12-a113 ◽

2012 ◽

Vol 5 (11 Supplement) ◽

pp. A113-A113

Author(s):

Jennifer Drahos ◽

Manxia Wu ◽

William F. Anderson ◽

Katrina F. Trivers ◽

Jessica King ◽

...

Keyword(s):

United States ◽

Esophageal Cancer ◽

Cancer Incidence ◽

The United States ◽

Incidence Rates ◽

Regional Variations ◽

Cancer Incidence Rates

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Time trends in incidence, comorbidity, and mortality of ischemic stroke in Denmark (1996–2016)

Neurology ◽

10.1212/wnl.0000000000010647 ◽

2020 ◽

Vol 95 (17) ◽

pp. e2343-e2353

Author(s):

Adelina Yafasova ◽

Emil Loldrup Fosbøl ◽

Mia Nielsen Christiansen ◽

Naja Emborg Vinding ◽

Charlotte Andersson ◽

...

Keyword(s):

Ischemic Stroke ◽

Cox Regression ◽

Initial Level ◽

Age Groups ◽

Incidence Rates ◽

Lipid Lowering ◽

Mortality Risks ◽

Rate Ratios ◽

New Treatments ◽

First Time

ObjectiveTo examine whether the incidence, comorbidity, and mortality of first-time ischemic stroke changed in Denmark between 1996 and 2016 overall and according to age and sex using a nationwide cohort design.MethodsIn this cohort study, 224,617 individuals ≥18 years of age admitted with first-time ischemic stroke between 1996 and 2016 were identified through Danish nationwide registries. We calculated annual age-standardized incidence rates and absolute 30-day and 1-year mortality risks. Furthermore, we calculated annual incidence rate ratios using Poisson regression, odds ratios for 30-day mortality using logistic regression, and hazard ratios for 1-year mortality using Cox regression.ResultsThe overall age-standardized incidence rates of ischemic stroke per 1,000 person-years increased from 1996 (2.70 [95% confidence interval [CI] 2.65–2.76]) to 2002 (3.25 [95% CI 3.20–3.31]) and then gradually decreased to below the initial level until 2016 (1.99 [95% CI 1.95–2.02]). Men had higher incidence rates than women in all age groups except 18 to 34 and ≥85 years. Absolute mortality risk decreased between 1996 and 2016 (30-day mortality from 17.1% to 7.6% and 1-year mortality from 30.9% to 17.3%). Women between 55 and 64 and ≥85 years of age had higher mortality than men. Similar trends were observed for all analyses after multivariable adjustment. The prevalence of atrial fibrillation, hypertension, diabetes mellitus, and use of lipid-lowering medication increased during the study period.ConclusionsThe age-standardized incidence of first-time hospitalization for ischemic stroke increased from 1996 to 2002 and then gradually decreased to below the initial level until 2016. Absolute 30-day and 1-year mortality risks decreased between 1996 and 2016. These findings correspond to increased stroke prevention awareness and introduction of new treatments during the study period.

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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.

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