Changing patterns in presentation and therapy of esophagogastric junction cancers in the United States.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 22-22
Author(s):  
Roderich Schwarz ◽  
David D. Smith ◽  
Rebecca A. Nelson
Keyword(s):  
Esophagogastric Junction ◽  
The United States ◽  
Tumor Location ◽  
Tnm Staging ◽  
Incidence Rates ◽  
Preoperative Radiation ◽  
Lower Stage ◽  
Siewert Classification ◽  
Changing Patterns ◽  
The U.S

22 Background: Esophagogastric junction cancer (EGJC) has recently been included within the esophageal cancer (EC) AJCC TNM staging criteria. Trends in clinical presentation, therapeutic approach and outcomes are of interest. Methods: We identified EGJCs from the U.S. population SEER database and examined incidence, demographic, therapeutic and outcomes information. Siewert classification-related EGJC subtype-associated findings were also examined. Results: EGJC age-adjusted incidence rates (x10-5) have increased from 3.3 in 1973 to 7.5 in 2009. While the incidence rate for females has remained around 2, rates in males have increased from 6 to 13. Among 30,710 EGJC patients diagnosed between 1992 and 2009, potentially curative resection increased from 31% to 36% and radiation increased from 32% to 41% (p<0.0001). For resected EGJCs, significant trends over time include: increased total LN count (mean: 15.5 vs. 12.3), fewer positive LNs (3.1 vs. 4), smaller tumor size (29% vs. 36% >5 cm), lower T category (39% vs. 29% T1/2), lower N category (42% vs. 35% N0), lower stage group (29% vs. 38% stage 3/4), increased preoperative radiation (26% vs. 3%), decreased 90-day mortality (6.5 vs. 14.1%), longer overall survival (OS, median: 2.9 vs. 1.7 years) and longer disease-specific survival (median: 3.9 vs. 2.0 years) (all at p<0.0001). Multivariate predictors of OS include TNM categories, age, ethnicity, radiation, and total LN count (all at p<0.0001). There were significant differences in stage-for-stage OS between EC subtypes based on histology and primary tumor location, and in DSS between EGJC subtypes (Siewert I, II or III) as well. Conclusions: EGJC incidence rates, diagnosis and treatment have undergone significant changes within the U.S. population. The regional dissection extent remains an area of importance as it is associated with OS. Comparisons of various survival outcomes do not support using the same staging criteria for EGJC as for EC.

Abstract 3039: Temporal Trends in the Prevalence of Dermatoses in Patients with Stroke and Transient Ischemic Attack in the United States

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Erine A Kupetsky ◽  
Mitch Maltenfort ◽  
Scott Waldman ◽  
Fred Rincon
Keyword(s):  
Temporal Trends ◽  
Progressive Systemic Sclerosis ◽  
The United States ◽  
Primary Diagnosis ◽  
Incidence Rates ◽  
Secondary Diagnosis ◽  
Cross Sectional ◽  
Total Prevalence ◽  
Skin Conditions ◽  
The U.S

Background. We sought to determine the prevalence of skin conditions traditionally associated with acute ischemic stroke (AIS) and transient ischemic attacks (TIA) in the U.S. Methods. This is a cross-sectional study of data derived from the National Inpatient Sample from 1988-2008. We searched for admissions of patients <18 years, with a primary diagnosis of AIS, TIA, and the following secondary diagnoses (dermatoses): Psoriasis, Behcet’s Disease (BD), Dermatomyositis (DM), Systemic Lupus Eythematosis (SLE), Pseudoxanthoma Elasticum (PXE), Progressive Systemic Sclerosis or Scleroderma (SCD), and Bullous Pemphigoid (BP). Definitions were based on ICD9CM codes, and adjusted incidence rates for the U.S census and prevalence proportions were then calculated. Results. Over the 20-year period, we identified 9,085,147 admissions that corresponded to a primary diagnosis of AIS and TIA of which 53,060 had a secondary diagnosis of dermatoses, for a total prevalence of 0.6%. The adjusted rate of AIS/TIA increased from 71/100,000 in 1988 to 200/100,000 in 2008. Among the secondary diagnosis, the most prevalent condition after AIS/TIA admissions was SLE (54%), psoriasis (34%), SCD (9%), BP (2%), DM (1%), PXE (0.5%), and BD (0.14%). The prevalence of these dermatoses increased from 0.2% in 1988 to 0.8% in 2008 ( Figure 1 ). Conclusion. Despite an overall increase in the prevalence of dermatoses, these skin conditions remain a rare occurrence in AIS/TIA. The over-representation of traditional risk factors for AIS/TIA in patients with these dermatoses, may explain the observed epidemiological phenomenon.

First Report of National Estimates of the Incidence of Myelodysplastic Syndromes and Chronic Myeloproliferative Disorders from the U.S. SEER Program.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 247-247 ◽  
Author(s):  
Dana E. Rollison ◽  
Matthew Hayat ◽  
Martyn Smith ◽  
Sara S. Strom ◽  
William D. Merritt ◽  
...  
Keyword(s):  
Myelodysplastic Syndromes ◽  
Disease Incidence ◽  
Myeloproliferative Disorders ◽  
The United States ◽  
Incidence Rates ◽  
Age At Diagnosis ◽  
Seer Program ◽  
Refractory Anemia ◽  
Chronic Myeloproliferative Disorders ◽  
The U.S

Abstract BACKGROUND: Incidence rates for myelodysplastic syndromes (MDS) and chronic myeloproliferative disorders (CMD) in the United States were unavailable prior to the addition of these stem cell malignancies to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program and other central cancer registries in 2001. Description of national incidence rates for 2001–2003 will provide an important baseline for future studies of secular trends and allow for the examination of rates by selected demographic factors to define risk profiles of these malignancies in the American population. METHODS: Incidence rates of MDS and CMD were calculated for 18 SEER areas between 2001–2003. These rates were stratified by disease subtype using the FAB classification (including chronic myelomonocytic leukemia [CMML]) with the addition of the WHO deletion 5q category, sex, age at diagnosis and race. Based on the observed SEER incidence rates, counts were estimated for the entire U.S. population. RESULTS: In 2003, 2,538 cases of MDS and 1,421 cases of CMD were observed for all 18 SEER areas combined. Similar numbers of cases were observed in 2001 and 2002. Age-adjusted incidence rates for 2001–2003 were significantly higher among males than females for MDS (4.5 per 100,000 in males vs. 2.7 per 100,000 in females, p <0.0001) and CMD (2.4 per 100,000 in males vs. 1.7 per 100,000 in females, p<0.0001). This gender rate difference was observed consistently across all disease subtypes, including refractory anemia (2.0 per 100,000 in males vs. 1.2 per 100,000 in females (p<0.0001). Incidence rates were significantly associated with age at diagnosis for both MDS (p=0.01) and CMD (p=0.001), and were highest among White, non-Hispanics (2.4 per 100,000 for CMD; 4.2 per 100,000 for MDS). An estimated national total of 14,648 cases of MDS (including CMML) and CMD were diagnosed in 2003, with overall incidence rates for MDS and CMD of 3.1 and 1.9 per 100,000, respectively. The MDS incidence rate for the U.S. is remarkably similar to those previously reported from European countries including England and Wales (3.6 per 100,000), Germany (4.1 per 100,000), Sweden (3.6 per 100,000) and France (3.2 per 100,000). Estimated incidence rates in the U.S. were greater among men than women for all diseases, including CMML (0.40 per 100,000 in males versus 0.3 per 100,000 in females, p< 0.0001). Disease incidence increased with age for MDS, CMD, and CMML, although the increase was greatest for MDS, with an approximate five-fold difference in estimated rates for those diagnosed at ages 60–69 years vs. 80 years and older (7.4 per 100,000 vs. 36.3 per 100,000). The increase in MDS incidence with age was greater for males than females, whereas the age-related increase in CMD and CMML incidence was similar across sexes. Rates of CMD, MDS and CMML were all estimated to be highest among White, non-Hispanics. CONCLUSION: Male sex and advanced age are important risk factors for the development of CMD and MDS. Diagnostic recording differences may underestimate the total annual U.S. MDS and CMD case burden. Future prevention intervention and disease causality studies of MDS and CMD should target high-risk groups.

scholarly journals Lifestyle Effects on the Risk of Transmission of COVID-19 in the United States: Evaluation of Market Segmentation Systems

2021 ◽  
Vol 18 (9) ◽  
pp. 4826
Author(s):  
Esra Ozdenerol ◽  
Jacob Seboly
Keyword(s):  
United States ◽  
The United States ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Statistical Testing ◽  
Average Risk ◽  
County Level ◽  
Household Level ◽  
The Impact ◽  
The U.S

The aim of this study was to associate lifestyle characteristics with COVID-19 infection and mortality rates at the U.S. county level and sequentially map the impact of COVID-19 on different lifestyle segments. We used analysis of variance (ANOVA) statistical testing to determine whether there is any correlation between COVID-19 infection and mortality rates and lifestyles. We used ESRI Tapestry LifeModes data that are collected at the U.S. household level through geodemographic segmentation typically used for marketing purposes to identify consumers’ lifestyles and preferences. According to the ANOVA analysis, a significant association between COVID-19 deaths and LifeModes emerged on 1 April 2020 and was sustained until 30 June 2020. Analysis of means (ANOM) was also performed to determine which LifeModes have incidence rates that are significantly above/below the overall mean incidence rate. We sequentially mapped and graphically illustrated when and where each LifeMode had above/below average risk for COVID-19 infection/death on specific dates. A strong northwest-to-south and northeast-to-south gradient of COVID-19 incidence was identified, facilitating an empirical classification of the United States into several epidemic subregions based on household lifestyle characteristics. Our approach correlating lifestyle characteristics to COVID-19 infection and mortality rate at the U.S. county level provided unique insights into where and when COVID-19 impacted different households. The results suggest that prevention and control policies can be implemented to those specific households exhibiting spatial and temporal pattern of high risk.

Incidence rates for anal cancer in the United States: 1980-2009.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 357-357 ◽  
Author(s):  
Lauren A. Eberly ◽  
Charles Wiggins ◽  
Itzhak Nir ◽  
Katherine T. Morris ◽  
John C. Russell ◽  
...  
Keyword(s):  
Anal Cancer ◽  
Squamous Cell ◽  
Direct Method ◽  
Cell Cancer ◽  
Temporal Trends ◽  
The United States ◽  
Incidence Rates ◽  
Seer Program ◽  
Anal Squamous Cell Carcinoma ◽  
The U.S

357 Background: Anal squamous cell carcinoma (SCC) is rare, but results in significant morbidity and mortality. The aim of this study was to characterize the trends of anal SCC in the U.S. between 1980-2009. Methods: Subjects were identified from records in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. The study included incident malignant squamous cell cancer of the anus, anal canal, and anorectum diagnosed among nine core areas of the SEER program from 1980-2009. Average annual age-adjusted incidence rates were calculated by the direct method with the U.S. 2000 standard population. 95% confidence intervals were calculated using the Tiwari adjustment. Temporal trends were assessed by joinpoint regression. Results: Incidence rates of anal cancer in the U.S. more than doubled during this period. A linear increase in anal cancer incidence rates was observed with an Annual Percent Change (APC) of 4.6 (p<0.01) for all races and both sexes-combined. Incidence rates were consistently greater for women than men, however, the increase in incidence rates was greater for men (APC=5.4, p<0.01) than for women (APC=4.3, p<0.01). Similar trends were seen for whites and blacks. Conclusions: Anal cancer is a relatively rare disease, yet incidence rates increased dramatically in the U.S. over the last three decades. Correlation of this increased incidence with HPV infection remains to be determined. [Table: see text]

scholarly journals EPID-28. WHAT DO PATTERNS OF “UNCLASSIFIED” BRAIN TUMORS TELL US ABOUT INCIDENCE RATES OF NON-MALIGNANT BRAIN TUMORS IN CANADA?

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi80-vi80
Author(s):  
Trenton Smith ◽  
Emily Walker ◽  
Yan Yuan ◽  
Faith Davis ◽  
Joseph Megyesi
Keyword(s):  
Brain Tumors ◽  
Cancer Registry ◽  
Cancer Registries ◽  
The United States ◽  
Incidence Rates ◽  
Control Measures ◽  
Malignant Brain Tumors ◽  
Canadian Population ◽  
Subtype A ◽  
The U.S

Abstract BACKGROUND Patients with non-malignant brain tumors (NMBT) can experience significant morbidity and mortality; the degree of which varies by histological subtype. A recent report on all primary brain tumors in Alberta (AB), British Columbia (BC), Manitoba (MB) and Ontario (ON) showed 19.1% of NMBT were categorized as ‘unclassified’. Missing data on histological subtypes encumbers efforts to understand the burden of disease associated with NMBT. The purpose of this analysis was to examine the distribution of unclassified tumors across participating provinces to identify targets for improved surveillance. METHODS Data were provided from cancer registries in AB, BC,MB, and ON. Age Standardized Incidence Rates (ASIR) and frequencies were estimated using SAS 9.4. Given data from the United States (U.S) is accurate and the population is comparable, ASIR of NMBT in the U.S were used as expected values in this analysis. The 2011 Canadian Population and the 2000 US population were used for standardization to compare within Canada and to U.S data respectively. RESULTS The ASIR of total NMBT and was highest in ON, relative to other participating provinces and similar to that of the U.S (15.25 and 15.91 cases/100,000 person-years, respectively). However, ON had an ASIR about 10 times higher than other provinces for unclassified tumors (ON:6.3 cases/100,000 person-years; BC: 0.4 cases/100,000 person-years; AB:0.3 cases/100,000 person-years; and MB:0.6 cases/100,000 person-years). When unclassified tumors were excluded from the analysis, the ASIR of NMBT was similar across participating provinces. CONCLUSIONS Findings from this analysis indicate that the Ontario provincial cancer registry has complete data on total NMBT cases. However, the high ASIR of unclassified cases in the NMBT category indicates that quality control measures could be improved. Further examination of the unclassified cases in ON could be used to improve the accuracy of the ON cancer registry and the completeness of other province’s registries.

scholarly journals Updates in the 8th edition of the TNM staging system for esophagus and esophagogastric junction cancer

2020 ◽  
Vol 50 (8) ◽  
pp. 847-851 ◽  
Author(s):  
Hiroyuki Daiko ◽  
Ken Kato
Keyword(s):  
Esophagogastric Junction ◽  
Tnm Classification ◽  
Cancer Control ◽  
Main Tool ◽  
Staging System ◽  
Tumor Location ◽  
Tnm Staging ◽  
7Th Edition ◽  
Definition Of ◽  
8Th Edition

Abstract The tumor–node metastasis (TNM) classification, originally developed in 1943 and subsequently adopted by the Union for International Cancer Control and the American Joint Committee on Cancer, is regularly updated based on new information and developments. The TNM classification system is the main tool used for both clinical and pathological staging of cancers worldwide. The 8th edition of the TNM classification for esophageal and esophagogastric junction (EGJ) cancer, released in 2017, was updated from the 7th edition based on additional data supplied by the Worldwide Esophageal Cancer Collaboration group. We summarize the main changes between the 7th and 8th editions of this TNM classification. Notable changes included separate clinical, pathological and pathological prognostic staging for adenocarcinomas and squamous cell carcinomas. Pathological prognostic staging was also improved by updating the T- and N-factors regarding histopathological differentiation and tumor location, respectively. The definition of EGJ cancer was changed from tumors centered within 5 cm to tumors within 2 cm of the EGJ. These updates to the TNM classification will help to improve the personalized management and treatment of patients with esophageal and EGJ cancers.

An American Language

2018 ◽  
Author(s):  
Rosina Lozano
Keyword(s):  
United States ◽  
National Policy ◽  
The United States ◽  
Spanish Language ◽  
Spanish Speakers ◽  
Language Recognition ◽  
Political Language ◽  
Political Issue ◽  
History Of ◽  
The U.S

An American Language is a political history of the Spanish language in the United States. The nation has always been multilingual and the Spanish language in particular has remained as an important political issue into the present. After the U.S.-Mexican War, the Spanish language became a language of politics as Spanish speakers in the U.S. Southwest used it to build territorial and state governments. In the twentieth century, Spanish became a political language where speakers and those opposed to its use clashed over what Spanish's presence in the United States meant. This book recovers this story by using evidence that includes Spanish language newspapers, letters, state and territorial session laws, and federal archives to profile the struggle and resilience of Spanish speakers who advocated for their language rights as U.S. citizens. Comparing Spanish as a language of politics and as a political language across the Southwest and noncontiguous territories provides an opportunity to measure shifts in allegiance to the nation and exposes differing forms of nationalism. Language concessions and continued use of Spanish is a measure of power. Official language recognition by federal or state officials validates Spanish speakers' claims to US citizenship. The long history of policies relating to language in the United States provides a way to measure how U.S. visions of itself have shifted due to continuous migration from Latin America. Spanish-speaking U.S. citizens are crucial arbiters of Spanish language politics and their successes have broader implications on national policy and our understanding of Americans.

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