scholarly journals Compression, expansion, or maybe both? Growing inequalities in lung cancer in Germany

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242433
Author(s):  
Fabian Tetzlaff ◽  
Jelena Epping ◽  
Heiko Golpon ◽  
Juliane Tetzlaff
Keyword(s):  
Lung Cancer ◽  
Social Inequalities ◽  
Income Group ◽  
Incidence Rates ◽  
Vulnerable Groups ◽  
Survival Models ◽  
Gender Inequalities ◽  
Life Years ◽  
Incidence And Mortality ◽  
Health Insurance Provider

Background Lung Cancer (LC) is one of the most common malign diseases worldwide. So far, it is unclear if the development of LC incidence and mortality leads to morbidity compression or expansion and whether these developments differ by socioeconomic characteristics. This study analyses time trends in social and gender inequalities in life years with and without LC in Germany. Methods The study is based on data of a large German statutory health insurance provider (N = 2,511,790). Incidence and mortality risks were estimated from multistate survival models. Trends in life years with and without LC were analysed using multistate life table analyses. All analyses were performed separately for gender, time period (2006–2009 and 2014–2017), and income group (<60% and ≥60% of the German average income). Results Among men, declining LC incidence rates resulted in gains of life years free of LC and declining LC- affected life years and led to a relative compression, which was strongest in men with higher incomes. Among women, a clear increase in life years with LC led to an expansion of the lifespan affected by LC. This expansion was mainly driven by increasing incidence rates in women with low incomes. Overall, income inequalities in LC increased in both genders. Conclusions Our analyses reveal that developments in the length of life affected by LC differed substantially by gender and income and led to widening health inequalities over time. Public health efforts should mainly focus on vulnerable groups to reduce the persisting social inequalities in LC.

scholarly journals Social inequalities and the pandemic of COVID-19: the case of Rio de Janeiro

2021 ◽  
pp. jech-2020-214724
Author(s):  
Julio Silva ◽  
Marcelo Ribeiro-Alves
Keyword(s):  
Socioeconomic Factors ◽  
Rio De Janeiro ◽  
Social Inequalities ◽  
Developed Countries ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Vulnerable Groups ◽  
Early Stages ◽  
Incidence And Mortality ◽  
Health Gradient

BackgroundThe novel coronavirus (SARS-CoV-2) is a global pandemic. The lack of protective vaccine or treatment led most of the countries to follow the flattening of the infection curve with social isolation measures. There is evidence that socioeconomic inequalities have been shaping the COVID-19 burden among low and middle-income countries. This study described what sociodemographic and socioeconomic factors were associated with the greatest risk of COVID-19 infection and mortality and how did the importance of key neighbourhood-level socioeconomic factors change over time during the early stages of the pandemic in the Rio de Janeiro municipality, Brazil.MethodsWe linked socioeconomic attributes to confirmed cases and deaths from COVID-19 and computed age-standardised incidence and mortality rates by domains such as age, gender, crowding, education, income and race/ethnicity.ResultsThe evidence suggests that although age-standardised incidence rates were higher in wealthy neighbourhoods, age-standardised mortality rates were higher in deprived areas during the first 2 months of the pandemic. The age-standardised mortality rates were also higher in males, and in areas with a predominance of people of colour, which are disproportionately represented in more vulnerable groups. The population also presented COVID-19 ‘rejuvenation’, that is, people became risk group younger than in developed countries.ConclusionWe conclude that there is a strong health gradient for COVID-19 death risk during the early stages of the pandemic. COVID-19 cases continued to move towards the urban periphery and to more vulnerable communities, threatening the health system functioning and increasing the health gradient.

scholarly journals Social inequalities in mild and severe myocardial infarction: how large is the gap in health expectancies?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juliane Tetzlaff ◽  
Siegfried Geyer ◽  
Mechthild Westhoff-Bleck ◽  
Stefanie Sperlich ◽  
Jelena Epping ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Social Inequalities ◽  
Mortality Risks ◽  
Socially Disadvantaged ◽  
Life Years ◽  
Incidence And Mortality ◽  
Low Incomes ◽  
Health Insurance Provider ◽  
Length Of Life ◽  
German Statutory Health Insurance

Abstract Background Acute myocardial infarction (MI) remains a frequent health event and a major contributor to long-term impairments globally. So far, research on social inequalities in MI incidence and mortality with respect to MI severity is limited. Furthermore, evidence is lacking on disparities in the length of life affected by MI. This study investigates social inequalities in MI incidence and mortality as well as in life years free of MI and affected by the consequences of mild or severe MI. Methods The study is based on data of a large German statutory health insurance provider covering the years 2008 to 2017 (N = 1,253,083). Income inequalities in MI incidence and mortality risks and in life years with mild or severe MI and without MI were analysed using multistate analyses. The assessment of MI severity is based on diagnosed heart failure causing physical limitations. Results During the study period a total of 39,832 mild MI, 22,844 severe MI, 276,582 deaths without MI, 15,120 deaths after mild MI and 16,495 deaths after severe MI occurred. Clear inequalities were found in MI incidence and mortality, which were strongest among men and in severe MI incidence. Moreover, substantial inequalities were found in life years free of MI in both genders to the disadvantage of those with low incomes and increased life years after mild MI in men with higher incomes. Life years after severe MI were similar across income groups. Conclusions Social inequalities in MI incidence and mortality risks led to clear disparities in the length of life free of MI with men with low incomes being most disadvantaged. Our findings stress the importance of primary and secondary prevention focusing especially on socially disadvantaged groups.

scholarly journals Widening or narrowing income inequalities in myocardial infarction? Time trends in life years free of myocardial infarction and after incidence

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Juliane Tetzlaff ◽  
Fabian Tetzlaff ◽  
Siegfried Geyer ◽  
Stefanie Sperlich ◽  
Jelena Epping
Keyword(s):  
Myocardial Infarction ◽  
Low Income ◽  
Income Group ◽  
Federal State ◽  
Men And Women ◽  
Mortality Risks ◽  
Income Inequalities ◽  
Life Years ◽  
Incidence And Mortality ◽  
Over Time

Abstract Background Despite substantial improvements in prevention and therapy, myocardial infarction (MI) remains a frequent health event, causing high mortality and serious health impairments. Previous research lacks evidence on how social inequalities in incidence and mortality risks developed over time, and on how these developments affect the lifespan free of MI and after MI in different social subgroups. This study investigates income inequalities in MI-free life years and life years after MI and whether these inequalities widened or narrowed over time. Methods The analyses are based on claims data of a large German health insurance provider insuring approximately 2.8 million individuals in the federal state Lower Saxony. Trends in income inequalities in incidence and mortality were assessed for all subjects aged 60 years and older by comparing the time periods 2006–2008 and 2015–2017 using multistate survival models. Trends in the number of life years free of MI and after MI were calculated separately for income groups by applying multistate life table analyses. Results MI incidence and mortality risks decreased over time, but declines were strongest among men and women in the higher-income group. While life years free of MI increased in men and women with higher incomes, no MI-free life years were gained in the low-income group. Among men, life years after MI increased irrespective of income group. Conclusions Income inequalities in the lifespan spent free of MI and after MI widened over time. In particular, men with low incomes are disadvantaged, as life years spent after MI increased, but no life years free of MI were gained.

scholarly journals Trends in cancer incidence in Uruguay:2002 - 2015

2019 ◽  
Author(s):  
Mariela Garau ◽  
Carina Musetti ◽  
Rafael Alonso ◽  
Enrique Barrios
Keyword(s):  
Lung Cancer ◽  
Cancer Registry ◽  
Cancer Incidence ◽  
Incidence Rates ◽  
Medical Community ◽  
Screening Programs ◽  
National Cancer Registry ◽  
Incidence Trends ◽  
Incidence And Mortality ◽  
Life Style Changes

Background: Uruguay is the southamerican country which has the highest cancer incidence and mortality rates. The National Cancer Registry collects data on cancer cases nationwide since 1989 and has reached high quality standards in the last decades. This is the first report on incidence trends. Methods: Data from the National Cancer Registry of all new cases of invasive cancer from twelve sites diagnosed in 2002-2015 was analyzed. Age-standardized rates were calculated. Trends of incidence rates were analyzed using joinpoint regression models. Results For both, men and women, incidence rates trends for all cancer sites, colo-rectal and bladder cancer remained stable. Esophageal and gastric cancers descend while Thyroid and kidney cancer incidence increased. In men lung cancer decreased; testicular cancer increased, and prostate cancer increased at the beginning of the period and decreased in the final years. In women; lung cancer increased, breast cancer remained stable and cervical cancer presented a significant decline from 2005 to 2010 and reached a plateau since then. Conclusion: Cancer incidence dynamics are complex and affected not only by Public Health policies such as tobacco control, vaccination and screening programs, but also by environmental and life style changes and the attitude of the medical community towards the application of diagnostic and therapeutic tools. The aim of this paper is to analyze cancer incidence time trends in the country and provide possible explanations to them.

scholarly journals The Impact of Delays During the Pandemic Months on Survival of Lung Cancer Patients in Canada in 2020.

2021 ◽  
Author(s):  
Luv Khandelwal ◽  
Housne Begum ◽  
Pria Nippak
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Incidence Rates ◽  
Cancer Statistics ◽  
Lung Cancer Patients ◽  
Life Years ◽  
Statistics Canada ◽  
Diagnosis Of Lung Cancer ◽  
Delays In Diagnosis ◽  
The Impact

Abstract Objective Most cancer deaths in the world are due to lung cancer and delays in diagnosis and treatment sharply reduce survival in lung cancer patients. This study examined the impact of delays during the early months of the pandemic on the survival of newly identified lung cancer patients in Canada in 2020. Methods The incidence of lung cancer, using population statistics from Statistics Canada and incidence rates from the Canadian Cancer Statistics in 2020, was estimated. Stage-wise incidences for each sex were calculated for each age group for each month of 2020. Using delay impact on each stage the final results were calculated. Results A total of 5,004 life years would have been lost due to 448 deaths in the long term (40 months) attributed to the delays caused during March, April, May and June in Canada. The estimated incidence for all stages of lung cancer for these months was 9,801 although the observed incidence was expected to be 6,571 due to reduced screenings. Hence, it was within the missing 3,231 cases that delays would occur. Over the short term (10 months) there are expected to be 151 early deaths and 273 deaths in the intermediate-term (20 months). Conclusion The COVID pandemic is estimated to result in increased mortality and fewer diagnosis’ of lung cancer patients in Canada in 2020.

scholarly journals LUNG CANCER INCIDENCE AND MORTALITY IN THE KHANTY-MANSI AUTONOMOUS OKRUG – YUGRA

2021 ◽  
Vol 20 (4) ◽  
pp. 30-38
Author(s):  
A. A. Mordovskii ◽  
A. A. Aksarin ◽  
A. M. Parsadanyan ◽  
M. D. Ter-Ovanesov ◽  
P. P. Troyan
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Mortality Rate ◽  
Cancer Incidence ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Lung Cancer Incidence ◽  
Cross Correlation Analysis ◽  
Incidence And Mortality ◽  
Khanty Mansi Autonomous

The aim of the study was to assess the lung cancer incidence and mortality in the Khanty-mansi autonomous okrug – Yugra during the period 1999–2019.Material and methods. We have studied the lung cancer incidence and mortality rates in Yugra over the last 21 years (1999–2019).Results. In Yugra, the lung cancer (lc) incidence rates increased by 24.7 % from 1999 to 2019, demonstrating higher rates than those in the Russian Federation (RF), where lc incidence rates decreased by 20.3 %. In 2019, the age-standardized incidence rate was 30.5 per 100,000 (22.7 for RF); the age-standardized mortality rate was 16.4 per 100,000 (18.4 for RF). The mortality rate from lc in Yugra was 9.6 times higher in males than in females (35.5 vs. 3.7 per 100,000). The cross-correlation analysis revealed a correlation between the lc incidence/mortality and air pollution in Yugra. The main carcinogens in Yugra were formaldehyde, phenol, nitrogen dioxide, and benzapyrene. The assessment of the relationship between the age-standardized lc incidence/mortality rates and the amount of pollutants emitted into the atmosphere revealed that their synergistic effects with tobacco smoking can double the risk of lung cancer development. The increase in the number of chest computed tomography (ct) scans performed in the context of the pandemic caused by covid-19 infection led to an 18 % increase in the number of incidentally detected pulmonary nodules, of which 9 % of cases were diagnosed as lc.Conclusion. The lc incidence rates in Yugra tended to increase. The high rate of lc incidence is caused by man-made and natural factors, which requires the implementation of a screening program with the use of low-dose computed tomography in order to improve the early detection and prevention of this disease.

scholarly journals A nationwide population-based study of incidence and mortality of lung cancer in idiopathic pulmonary fibrosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Myung Jin Song ◽  
Song Yee Kim ◽  
Moo Suk Park ◽  
Min Jin Kang ◽  
Sang Hoon Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Cumulative Incidence ◽  
Medical Information ◽  
Population Based ◽  
Incidence Rates ◽  
Mortality Data ◽  
Survival Outcomes ◽  
Incidence And Mortality

AbstractIdiopathic pulmonary fibrosis (IPF) is an independent risk factor for lung cancer (LC) development; however, there are currently no clinical guidelines for LC surveillance in IPF. This study aimed to investigate the cumulative incidence and survival outcomes of LC in IPF. Using the National Health Insurance Service database, including medical information on people aged ≥ 40 years between 2011 and 2016, we identified IPF patients and confirmed the presence of comorbid LC. Patients diagnosed with IPF in 2011 were washed out, and mortality data were analyzed from 2012 to 2018. A total of 7277 newly diagnosed IPF patients were identified among Korean citizens aged ≥ 40 years (about 50 million people) between 2011 and 2016. Their average age was 71.5 years and 72.8% of them were male. The prevalence of LC in the IPF cases was 6.4%. The cumulative incidence rates of LC in IPF patients who did not have LC at the time of IPF diagnosis were 1.7%, 4.7%, and 7.0%, at 1, 3, and 5 years, respectively. The median time from IPF diagnosis to LC development was 16.3 (Interquartile range, 8.2–28.8) months. The survival rate was significantly lower in the IPF with LC group than the IPF without LC group (P < 0.001). We concluded that IPF increases LC risk, and LC weakens survival outcomes in IPF. Close surveillance for LC development is mandatory for patients with IPF.

Cancer incidence and mortality in the USA Astronaut Corps, 1959–2017

2021 ◽  
pp. oemed-2020-107143
Author(s):  
Robert Reynolds ◽  
Mark P Little ◽  
Steven Day ◽  
Jacqueline Charvat ◽  
Steven Blattnig ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Colon Cancer ◽  
General Population ◽  
Cancer Incidence ◽  
Case Fatality ◽  
Incidence Rates ◽  
Cancer Case ◽  
Case Fatality Ratio ◽  
Incidence And Mortality ◽  
The Us

ObjectivesCancer incidence and mortality are important outcomes in the surveillance of long-term astronaut health. We compare cancer incidence rates, cancer-specific mortality rates, and cancer case-fatality ratios in US astronauts with those in the US general population.MethodsWe use standardised incidence ratios (SIRs) and standardised mortality ratios (SMRs) to index the incidence and mortality of various cancers against rates in the US general population, from the US astronaut cohort inception in April 1959 through 31 December 2017. We compare the lethality of these cancers using the relative case-fatality ratio.ResultsOverall cancer incidence and mortality were slightly lower than expected from national rates with SIR 82 (95% CI 63 to 104) and SMR 72 (95% CI 44 to 111) with a modest 14% reduction in case-fatality ratio. Prostate cancer and melanoma skin cancer had significant increases in incidence, with SIR of 162 (95% CI 109 to 232) and 252 (95% CI 126 to 452), respectively, though only melanoma had a significant increase in mortality, with SMR 508 (95% CI 105 to 1485). Lung cancer had a significant deficit of both cases and deaths, while colon cancer had sizeable (but not significant) reductions in incidence and mortality.ConclusionsThe increase in incidence of melanoma is consistent with that observed in aircraft pilots, suggesting this may be associated with ultraviolet radiation or lifestyle factors rather than any astronaut-specific exposure. Reductions in lung cancer incidence and mortality, and trends towards such reductions in colon cancer, may be explained in part by healthy lifestyle, as well as differential screening among astronauts.

scholarly journals Socioeconomic inequalities in lung cancer – a time trend analysis with German health insurance data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fabian Tetzlaff ◽  
Jelena Epping ◽  
Juliane Tetzlaff ◽  
Heiko Golpon ◽  
Siegfried Geyer
Keyword(s):  
Lung Cancer ◽  
Health Insurance ◽  
Social Inequalities ◽  
Incidence Rates ◽  
Retirement Age ◽  
German Population ◽  
Health Insurance Data ◽  
Occupational Position ◽  
Working Age ◽  
Working Age Population

Abstract Background Lung Cancer (LC) is one of the most prevalent cancer diseases. Due to the lack of databases which allow the combination of information on individual socioeconomic status (SES) and cancer incidence, research on social inequalities in LC among the German population is rare. The aim of the study is to analyse time trends in social inequalities in LC in Germany. Methods The analyses are based on data of a large statutory health insurance provider. The data contain information on diagnoses, occupation and education (working age), and income (full age range) of the insurance population. Trends were analysed for two subpopulations (retirement age and working age) and stratified by sex. The analyses are based on incidence rates and proportional hazard models spanning the periods 2006–2009, 2010–2013 and 2014–2017. Results Incidence rates declined in men but increased in women. For men, inequalities were strongest in terms of income and the decline in incidence was most pronounced in middle- and higher-income men. Among women at retirement age, a reversed income gradient was found which disappeared in the second period. The educational gradient among the working-age population decreased over time due to the trend towards increasing incidence among individuals with higher education. Declining gradients were also found for occupational position. Conclusion The findings reveal considerable inequalities in LC and that trends vary with respect to SES, sex and age. Widening income inequalities were found in the retired population, while educational and occupational inequalities tend to narrow among the working-age population.

scholarly journals Clinicopathological Profile of Patients with Lung Carcinoma in a Tertiary Care Center

2020 ◽  
Author(s):  
M.T. Chandramouli ◽  
Giridhar Belur Hosmane
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Lung Carcinoma ◽  
Care Center ◽  
Tertiary Care ◽  
Smoking History ◽  
Tertiary Care Center ◽  
Cell Type ◽  
Lung Cancer Patients ◽  
Incidence And Mortality

Abstract Introduction Among malignant diseases, lung carcinoma is the most common cancer in men worldwide in terms of both incidence and mortality. Its increasing incidence in developing countries like India is an important public health problem. This work aimed to study the demographic, clinical, radiological, and histological features of patients with confirmed lung cancer. Materials and Methods A total of 50 patients with histologically confirmed lung cancer at a tertiary care center in India from August 2016 to September 2018 were studied and analyzed. Results Out of 50 diagnosed lung cancer patients, 86% were men and 14% women; 31 (62%) patients were aged more than 60 years. Majority were smokers (84%) and all were men. Cough (94%) was the most common presenting symptom followed by dyspnea (68%), chest pain (48%), and hemoptysis (38%). Of the 50 patients, 29 (58%) had soft tissue density mass lesion on radiograph. Squamous cell carcinoma (SCC) was the diagnosed histological cell type in 24 (48%) patients and adenocarcinoma in 21 (42%) patients. Distant metastasis was observed in 20 (40%) patients. Conclusion In this study, the most common histopathological cell type is SCC. Patients aged more than 50 years and smokers are at high risk of lung cancer. Patients with a smoking history and persistent respiratory symptoms should be promptly evaluated for lung malignancy.

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