A Significant Decrease in the Incidence of Shigellosis in Israel during COVID-19 Pandemic

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes COVID-19 and is mostly person-to-person transmitted through respiratory droplets. The implications of the strategies implemented to prevent COVID-19 transmission on other infectious diseases are unclear. We aimed to appraise trends in the incidence of salmonellosis, shigellosis and campylobacteriosis in Israel during COVID-19 pandemic. Positive stool samples for Salmonella, Shigella and Campylobacter are reported on a monthly basis to the Israel Center for Disease Control from sentinel laboratories, within the framework of a surveillance network of bacterial culture-proven enteric diseases. Age-adjusted incidence rates per 100,000 of shigellosis, salmonellosis and campylobacteriosis were calculated. Mean rates before and after the local onset of COVID-19 pandemic in Israel were compared and Relative Risk Reduction (RRR) was calculated. Joinpoint was used to evaluate secular trends. The mean age-adjusted incidence rate of shigellosis in March–July 2020 was lower than the rate observed in March–July 2018–2019 (RRR = 86.6%), but also decreased for salmonellosis (RRR = 33.0%) and campylobacteriosis (RRR = 30.0%). Using Joinpoint we have shown that the decrease observed for shigellosis was significantly sharper (Annual Percent Change (APC) = −77.7) between February 2020 and May 2020 than for salmonellosis (APC = −14.0) between July 2019 and April 2020 and for campylobacteriosis (APC = −1.1) between January 2018 and July 2020. The preventive measures applied to reduce transmission of COVID-19, including social distancing and hand washing, were ecologically associated with a decreased risk of bacterial enteric diseases in Israel. The association was strongest for shigellosis, a disease that is mostly person-to-person transmitted, as compared to salmonellosis and campylobacteriosis which are mostly foodborne transmitted.

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Dengue Fever in Italy: The “Eternal Return” of an Emerging Arboviral Disease

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed7010010 ◽

2022 ◽

Vol 7 (1) ◽

pp. 10

Author(s):

Matteo Riccò ◽

Simona Peruzzi ◽

Federica Balzarini ◽

Alessandro Zaniboni ◽

Silvia Ranzieri

Keyword(s):

Incidence Rate ◽

Central Italy ◽

Denv Infection ◽

Incidence Rates ◽

Annual Incidence ◽

Annual Reports ◽

Foreign Born ◽

Time Period ◽

Adjusted Incidence Rate ◽

Adjusted Incidence

Enhanced surveillance for dengue virus (DENV) infections in Italy has been implemented since 2012, with annual reports from the National Health Institute. In this study, we summarize available evidence on the epidemiology of officially notified DENV infections from 2010–2021. In total, 1043 DENV infection cases were diagnosed, and most of them occurred in travelers, with only 11 autochthonous cases. The annual incidence rates of DENV infections peaked during 2019 with 0.277 cases per 100,000 (95% confidence interval [95% CI] 0.187–0.267), (age-adjusted incidence rate: 0.328, 95% CI 0.314–0.314). Cases of DENV were clustered during the summer months of July (11.4%), August (19.3%), and September (12.7%). The areas characterized by higher notification rates were north-western (29.0%), and mostly north-eastern Italy (41.3%). The risk for DENV infection in travelers increased in the time period 2015–2019 (risk ratio [RR] 1.808, 95% CI 1.594–2.051) and even during 2020–2021 (RR 1.771, 95% CI 1.238–2.543). Higher risk for DENV was additionally reported in male subjects compared with females subjects, and aged 25 to 44 years, and in individuals from northern and central Italy compared to southern regions and islands. In a multivariable Poisson regression model, the increased number of travelers per 100 inhabitants (incidence rate ratio [IRR] 1.065, 95% CI 1.036–1.096), the incidence in other countries (IRR 1.323, 95% CI 1.165–1.481), the share of individuals aged 25 to 44 years (IRR 1.622, 95% CI 1.338–1.968), and foreign-born residents (IRR 2.717, 95% CI 1.555–3.881), were identified as effectors of annual incidence. In summary, although the circulation of DENV remains clustered among travelers, enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.

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Substantial Within-Country Variation in the Incidence of Subarachnoid Hemorrhage: A Nationwide Finnish Study

Neurology ◽

10.1212/wnl.0000000000012129 ◽

2021 ◽

pp. 10.1212/WNL.0000000000012129

Author(s):

Ilari Rautalin ◽

Joni Valdemar Lindbohm ◽

Jaakko Kaprio ◽

Miikka Korja

Keyword(s):

Subarachnoid Hemorrhage ◽

Poisson Regression ◽

Causes Of Death ◽

Incidence Rates ◽

Poisson Regression Model ◽

Geographical Regions ◽

Adjusted Incidence Rate ◽

Rate Ratios ◽

Adjusted Incidence ◽

Finnish Study

Objective:To study whether the incidence of subarachnoid hemorrhage (SAH) varies between geographical regions of Finland.Methods:By utilizing the nationwide Causes of Death and Hospital Discharge Registers, we identified all first-ever, hospitalized and sudden-death (dying before hospitalization) SAH events in Finland between 1998 and 2017. Based on the SAH patients’ home residence, we divided SAHs into five geographical regions: 1) Southern, 2) Central, 3) Western, 4) Eastern, and 5) Northern Finland. We calculated crude and European age-standardized (ESP2013) SAH incidence rates for each region, and used a Poisson regression model to calculate age-, sex- and calendar year-adjusted incidence rate ratios (IRRs) and 95% confidence intervals for regional and time-dependent differences.Results:During the total 106 510 337 cumulative person-years, we identified 9 443 first-ever SAH cases, of which 24% died before hospitalization. As compared to Western Finland, where the SAH incidence was the lowest (7.4 per 100 000 persons), the ESP-standardized SAH incidence was 1.4 times higher in Eastern (10.2 per 100 000 persons; adjusted IRR=1.37 (1.27–1.47)) and Northern Finland (10.4 per 100 000 persons; adjusted IRR=1.40 (1.30–1.51)). These differences were similar when men and women were analyzed independently. Although SAH incidence rates decreased in all five regions over two decades, the rate of decrease varied significantly by region.Conclusion:SAH incidence appears to vary substantially by region in Finland. Our results suggest that regional SAH studies can identify high-risk subpopulations, but can also considerably over- or underestimate incidence on a nationwide level.

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Epidemiology of Myeloproliferative Neoplasms in Norway

Blood ◽

10.1182/blood.v124.21.1858.1858 ◽

2014 ◽

Vol 124 (21) ◽

pp. 1858-1858

Author(s):

Christina Roaldsnes ◽

Anders Waage ◽

Mette Nørgaard ◽

Waleed Ghanima

Keyword(s):

Incidence Rate ◽

Cancer Registry ◽

Research Funding ◽

Myeloproliferative Neoplasms ◽

Relative Survival ◽

Incidence Rates ◽

Age At Diagnosis ◽

Jak2 Mutation ◽

Adjusted Incidence Rate ◽

Adjusted Incidence

Abstract Background: Polycythemia vera (PV), essential thrombocythemia (ET) and myelofibrosis (MF) are clonal hematological disorders collectively named as myeloproliferative neoplasms (MPN). Discovery of JAK2 mutation in 2005, altered WHO classification for MPN diagnosis in 2008 and availability of new treatment of MPN may have substantial effect on epidemiology of MPN. Published data on epidemiology of MPN after the discovery of JAK2 mutation and the introduction of 2008 WHO classifications for MPN, in particular on the prevalence of MPN, are scarce. We aimed to study the epidemiology of MPN in Norway and to explore the impact of JAK-2 mutation and new guidelines on the incidence of MPN using data from the Norwegian cancer registry. Method: We identified 2344 persons diagnosed with MPN from the Norwegian Cancer Registry diagnosed between 1995 and 2012. Registration of cancer in the Norwegian Cancer Registry is mandatory according to the law. We report age-adjusted incidence, prevalence and relative survival of MPN. Age adjusted incidence was reported for 2 years periods from 1995 to 2012. The prevalence was calculated according to the Norwegian population per 31.12.2011. Results: A total of 945 cases of PV was identified with a median age at diagnosis of 70 years; 471 males (50%) and 474 females (50%). The overall age-adjusted incidence rate both genders was 0.4/10⁵ in 1995-1997, 0.5/10⁵ in 1998-2000, 0.7/10⁵ in 2001-2003, 0.8/10⁵ in 2004-2007, 2008-2009 and 0.7/10⁵ in 2010-12. We identified a total of 762 cases of ET with a median age at diagnosis of 65 years, 297 males (39%) and 465 females (61%). The overall age adjusted incidence rate both genders being 0.3/10⁵ in 1995-1997 and 1998-2000, 0.5/10⁵ in 2001-2003 and 2004-2006, 0.9/10⁵ in 2007-2009 and 2010-2012. A total of 418 cases of MF was identified with a median age at diagnosis of 71 years; 243 males (58%) and 175 females (42%). Age adjusted incidence rates of both genders were 0.2/10⁵ from 1995-2006, 0.3/10⁵ in 2007-2009 and 0.5/10⁵ in 2010-2012. There were a total of 219 persons with unclassified MPN both genders,119 males (54%) and 100 females (46%) and age adjusted incidence rate varied from 0.1-0.2 to 0.1/10⁵ 1995-2012. Per 31.12.2011 the prevalence of PV, ET and MF was 9.2, 8.6 and 3.0 per 10⁵ inhabitants respectively. The survival curves for males and females for the three conditions are shown in the figure. Conclusions: This population-based study shows that the incidence of ET and MF almost doubled during the years 2007-2012 as compared to 1995-2006 as shown in the table. This increment in the incidence may possibly be related to improved diagnostics including the JAK2 mutation and the introduction of 2008 WHO-guidelines for MPN. Surprisingly, the discovery of JAK2 does not seem to have had impact on the incidence of PV as indicated by steady incidence rates since 2001. The relative survival was only slightly reduced for PV and ET, but substantially reduced for MF. Only 50% of patients with MF survive for more than 5 years. Table Incidence of MPN per 105 inhabitants during the period 1995 to 2012 in Norway 1995-97 1998-2000 2001-03 2004-06 2007-09 2010-12 PV 0.4 0.5 0.7 0.8 0.8 0.7 ET 0.3 0.3 0.5 0.5 0.9 0.9 MF 0.2 0.2 0.2 0.2 0.3 0.5 Figure showing the relative survival of PV, ET and MF Figure. showing the relative survival of PV, ET and MF Disclosures Roaldsnes: Novartis Norge AS: Research Funding. Ghanima:Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding.

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Rotavirus serotypes and electropherotypes identified among hospitalised children in São Luís, Maranhão, Brazil

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652005000500009 ◽

2005 ◽

Vol 47 (5) ◽

pp. 287-293 ◽

Cited By ~ 13

Author(s):

Cláudia Regina N. E. Luz ◽

Joana D'Arc P. Mascarenhas ◽

Yvone B. Gabbay ◽

Ana Regina B. Motta ◽

Telma Vitorina Ribeiro Lima ◽

...

Keyword(s):

Acute Diarrhoea ◽

Incidence Rates ◽

Northeastern Brazil ◽

Rotavirus Infection ◽

First Semester ◽

Rotavirus Gastroenteritis ◽

Positive Stool ◽

Stool Samples ◽

Rotavirus Infections

During June 1997-June 1999 rotavirus infection was screened in infants aged up to 2 years and hospitalised with acute diarrhoea in São Luís, Northeastern Brazil. Altogether, 128 stool samples were collected from diarrhoeic patients and additional 122 faecal specimens from age- and- temporal matched inpatients without diarrhoea were obtained; rotavirus positivity rates for these groups were 32.0% (41/128) and 9.8% (12/122), respectively (p < 0.001). Both electropherotyping and serotyping could be performed in 42 (79.2%) of the 53 rotavirus-positive stool samples. Long and short electropherotypes were detected at similar rates - 38.1% and 40.5% of specimens, respectively. Overall, a G serotype could be assigned for 35 (83.3%) of specimens, the majority of them (66.7%) bearing G1-serotype specificity. Taking both electropherotypes and serotypes together, G1 rotavirus strains displaying long and short RNA patterns accounted for 30.9% and 19.0% of tested specimens, respectively; all G2 strains had short electropherotype. Rotavirus gastroenteritis was detected year-round and, in 1998, the incidence rates tended to be higher during the second semester than in the first semester: 45.2% and 26.1% (p = 0.13), respectively. Rotavirus infections peaked at the second semester of life with frequencies of 30.1% and 13.5% for diarrhoeic children and controls, respectively. While the six rotavirus strains bearing G2-type specificity were circulating throughout the whole study period, G1 serotypes (n = 27) emerged as from June 1998 onwards, 20 (74.1%) of which clustering in 1998. These data underscore the importance of rotaviruses in the aetiology of severe infantile gastroenteritis in Northeastern Brazil and sustain the concept that a future vaccine should confer protection against more than one serotype.

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Sidedness Determines Clinical Characteristics and Survival Outcomes in Medullary Adenocarcinoma of the Colon

10.21203/rs.3.rs-589711/v1 ◽

2021 ◽

Author(s):

Andrew M. Blakely ◽

Rebecca A. Nelson ◽

Stanley A. Hamilton ◽

Lily L. Lai

Keyword(s):

Treatment Guidelines ◽

Cohort Analysis ◽

Colon Adenocarcinoma ◽

Patient Characteristics ◽

Incidence Rates ◽

Disease Stage ◽

Annual Percent Change ◽

Histologic Subtype ◽

Molecular Features ◽

Adjusted Incidence

Abstract Background: Colon medullary adenocarcinoma (MAC) is a rare histologic subtype. Clinical presentation and cancer outcomes of MAC, compared to colon adenocarcinoma (AC), remain incompletely described.Methods: Annual age-adjusted incidence rates were computed using Surveillance, Epidemiology, and End Results (2002–2017). A cohort analysis using the National Cancer Database (2010–2016) compared patient characteristics in an unmatched dataset and prognostic characteristics in a 1:1 matched subset. Results: Reported annual age-adjusted incidence of MAC has significantly increased, with an average annual percent change (APC) increase of 23.8% (95% CI: 19.2–28.6); concurrent AC incidence declined (APC: -2.8, 95% CI: -3.1– -2.8). Analyses of 1,018 MAC and 210,784 AC unmatched patients showed that MAC patients were more often older, female, and white, with higher disease stage, poorly-differentiated tumors, right-sided laterality, and lymphovascular invasion (all p<0.0001). Among those with known microsatellite status, instability was more prevalent among MAC than AC patients (82% vs. 24%, p<0.0001). Multivariate analyses of the matched dataset revealed that MAC histology was not independently associated with overall survival. However, when stratifying by laterality, left-sided MAC was associated with shorter survival when compared to right-sided MAC (HR 1.62, 95% CI: 1.13–2.32) and right-sided AC (HR 1.53, 95% CI: 1.12–2.11).Conclusions: The reported incidence of MAC is increasing, in contrast to the declining incidence of AC. MAC clinical and molecular features are distinct from AC and likely account for outcome differences. Overall, left-sided MAC was associated with the shortest OS. Molecular profiling may improve treatment guidelines for MAC.

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Differences in colon cancer incidence rates by latitude.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e14627 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e14627-e14627

Author(s):

Binay Kumar Shah ◽

Krishna Bilas Ghimire ◽

Barsha Nepal

Keyword(s):

Colon Cancer ◽

Incidence Rate ◽

Incidence Rates ◽

Southern Region ◽

Southern Latitude ◽

Northern Latitude ◽

The North ◽

Northern Regions ◽

Adjusted Incidence Rate ◽

Adjusted Incidence

e14627 Background: There is significant decrease in the ultraviolet B photons reaching the earth’s surface during November to February (Holick MF Am J Clin Nutr. 2004 Dec; 80(6 Suppl):1678S-88S). This results in little if any vitamin D3 production in the skin during this period. This study was conducted to evaluate difference in colon cancer age adjusted incidence rates in the northern (latitude ≥37o N) and the southern (latitude < 37oN) regions in the contiguous United States during 1973-2008. Methods: Patients, aged 20 years and older, who had been diagnosed with colong cancer during January 1973 and December 2008, were selected from the Surveillance, Epidemiology, and End Results (SEER) 13 database. Based on the counties’ centroid, northern (latitude ≥37o N) and southern (latitude < 37oN) regions were determined. We compared age adjusted incidence rates (AAIR) of colon cancer in the southern and northern regions among cohorts of patients categorized by age (≥20, 20-64, ≥65 years), gender (Men, Women) and Race (Caucasians, Blacks, Others). The AAIR was calculated per 100,000 population. We used SEER*Stat software to calculate age adjusted incidence rate, incidence ratio, confidence interval (CI, 95%) and P value. Results: There were 314,975 cases of colon cancer diagnosed among 608,245,557 US population during 1973-2008. The overall colon cancer AAIR was 57.1 per 100,000 population studied. The incidence rates were 49.1 in the south and 58.7 in the north of 37oN latitude, (95% CI 1.18-1.20, p<0.05). The AAIRs for patients in the age group 20-64 years were 17.9 and 18.8 in the southern and northern regions, (CI 95%, 1.0346-1.0697), p<0.0005 respectively. The incidence rates for patients aged ≥65 years were 194.3 and 243.9 in the southern and northern regions, (CI 95%, 1.0346-1.0697) p<0.0005. Similarly, the AAIRs were significantly higher in the northern region compared to southern region for both sexes and all ethnic groups. Conclusions: Colon cancer age-adjusted incidence rate is significantly higher in the Northern compared to the Southern region of the US. The higher incidence of colon cancer in the North may be related to lack of sunlight exposure and relative vitamin D deficiency.

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Temporal Trends in Incidence and Case Fatality of Intracerebral Hemorrhage: The Tromsø Study 1995-2012

Cerebrovascular Diseases Extra ◽

10.1159/000447719 ◽

2016 ◽

Vol 6 (2) ◽

pp. 40-49 ◽

Cited By ~ 7

Author(s):

Maria Carlsson ◽

Tom Wilsgaard ◽

Stein Harald Johnsen ◽

Anne Merete Vangen-Lønne ◽

Maja-Lisa Løchen ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Incidence Rate ◽

Temporal Trends ◽

Case Fatality ◽

Incidence Rates ◽

Adjusted Incidence Rate ◽

Adjusted Incidence ◽

Incident Cases ◽

Over Time ◽

Age And Sex

Background: The aim of this study was to explore temporal trends in incidence and case fatality rates of intracerebral hemorrhage (ICH) over the last two decades in a Norwegian municipality. Methods: Incident cases of primary ICH were registered in the period from 1995 through 2012 in 32,530 participants of the longitudinal population-based Tromsø Study. Poisson regression models were used to obtain incidence rates over time in age- and sex-adjusted and age- and sex-specific models. Case fatality rates were calculated and age- and sex-adjusted trends over time were estimated using logistic regression. Results: A total of 226 ICHs were registered. The age- and sex-adjusted incidence rate [95% confidence interval (CI)] in the overall population was 0.42 (0.37-0.48) per 1,000 person-years. Age-adjusted incidence rates were 0.53 (0.43-0.62) in men and 0.33 (0.26-0.39) in women. In individuals aged <75 years, the age- and sex-adjusted incidence rate was 0.27 (0.22-0.32) and in individuals aged ≥75 years, it was 2.42 (1.95-2.89) per 1,000 person-years. There was no significant change in incidence rates over time. The incidence rate ratio (95% CI) in the overall population was 0.73 (0.47-1.12) in 2012 compared with 1995. The overall 30-day case fatality (95% CI) was 23.9% (18.3-29.5) and did not change substantially over time [odds ratio in 2012 vs. 1995 = 0.83 (95% CI 0.27-2.52)]. Conclusion: No significant changes in incidence and case fatality rates of ICH were observed during the last two decades.

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Contemporary incidence and mortality rates of kidney cancer in the United States

Canadian Urological Association Journal ◽

10.5489/cuaj.1760 ◽

2014 ◽

Vol 8 (7-8) ◽

pp. 247 ◽

Cited By ~ 55

Author(s):

Giorgio Gandaglia ◽

Praful Ravi ◽

Firas Abdollah ◽

Abd-El-Rahman M. Abd-El-Barr ◽

Andreas Becker ◽

...

Keyword(s):

Kidney Cancer ◽

The United States ◽

Mortality Rates ◽

Incidence Rates ◽

Short Term ◽

Annual Percent Change ◽

Cancer Specific Survival ◽

Incidence And Mortality ◽

Short Term Mortality ◽

Adjusted Incidence

Introduction: This is a timely update of incidence and mortality for renal cell carcinoma (RCC) in the United States.Methods: Relying on the Surveillance, Epidemiology, and End Results (SEER) database, we computed age-adjusted incidence, mortality rates and 5-year cancer-specific survival (CSS) for patients with histologically confirmed kidney cancer between 1975 and 2009. Long-term (1975–2009) and short-term (2000–2009) trends were examined by joinpoint analysis, and quantified using the annual percent change (APC). The reported findings were stratified according to disease stage.Results: Age-adjusted incidence rates of RCC increased by +2.76%/year between 1975 and 2009 (from 6.5 to 17.1/100 000 person years, p < 0.001), and by +2.85%/year between 2000 and 2009 (p < 0.001). For the same time points, the corresponding APC for the incidence of localized stage were +4.55%/year (from 3.0 to 12.2/100 000 person years, p < 0.001), and +4.42%/year (p < 0.001), respectively. The incidence rates of regional stage increased by +0.88%/year between 1975 and 2009 (p < 0.001), but stabilized in recent years (2000–2009: +0.56%/year, p = 0.4). Incidence rates of distant stage remained unchanged in long- and short-term trends. Overall mortality rates increased by +1.72%/year between 1975 and 2009 (from 1.2 to 5.0/100 000 person-years, P<0.001), but stabilized between 1994 and 2004 (p = 0.1). Short-term mortality rates increased in a significant fashion by +3.14%/year only for localized stage (p < 0.001).Interpretation: In contemporary years, there is a persisting upward trend in incidence and mortality of localized RCC.

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MO514CARDIORENAL OUTCOMES AND MORTALITY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A MULTINATIONAL PROSPECTIVE COHORT STUDY (PROVALID)

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab087.0034 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Stefanie Thöni ◽

Felix Keller ◽

Sara Denicolo ◽

Susanne Eder ◽

Laszlo Rosivall ◽

...

Keyword(s):

Risk Factors ◽

The Netherlands ◽

Incidence Rate ◽

Composite Endpoint ◽

Incidence Rates ◽

European Countries ◽

All Cause Mortality ◽

Adjusted Incidence Rate ◽

Adjusted Incidence

Abstract Background and Aims PROVALID is a prospective, observational, multinational cohort study in 4000 patients with type 2 diabetes mellitus. Our aim was to determine the incidence rate of renal and cardiovascular endpoints, as well as all-cause-mortality in different European countries and to identify risk factors associated with the investigated outcomes. Method Potential risk factors associated with the investigated outcomes were identified by calculation of the incidence rate ratio. Crude and adjusted incidence rates for every country were estimated using generalized linear (poisson) regression models and corresponding 95 % confidence intervals were computed. Incidence rates were adjusted for different risk factors including age, sex, estimated GFR, albuminuria, HbA1c, LDL, HDL, total cholesterol, systolic blood pressure, BMI and cardiovascular and renal comorbidities; among these several show significant impact on outcomes. The renal outcome was a composite of a sustained decline in the estimated GFR of at least 40%, a sustained increase in albuminuria of at least 30 % including the progression from normo- to micro- or macroalbuminuria, end-stage kidney disease, or death from renal causes. The cardiovascular composite endpoint was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. Results 3461 participants of four European countries (Austria 18 %, Hungary 41 %, Netherlands 26 % and Scotland 15 %) with a mean follow up time of 3.9 years were included into this study. Participants from Poland were excluded due to missing follow-up data. In total, 9.2 % and 6.4 % participants reached the renal and cardiovascular composite endpoint, respectively. 7.0 % of the participants died within this timeframe. The adjusted incidence rate for the renal endpoint ranged from 14.5 to 25.3 (per 1000 patient-years) with no significant differences between countries. On average, the incidence rate was lower in Scotland (IR, 14.5; 95 % CI, 8.7 to 22.5) and in the Netherlands (IR, 15.7; 95 % CI, 10.9 to 21.8) compared to Hungary (IR, 25.3; 95 % CI, 20.7 to 30.6) and Austria (IR 21.3; 95 % CI, 16.2 to 27.5). The adjusted incidence rate for the cardiovascular endpoint ranged from 7.0 to 20.3 and was significantly lower in Hungary (IR, 7.0; 95 % CI, 5.1 to 9.3) and the Netherlands (IR, 7.6; 95 % CI, 4.4 to 12.2) compared to Austria (IR, 16.7; 95 % CI, 12.4 to 22.1) and Scotland (IR, 20.3; 95 % CI, 13.8 to 28.9). The adjusted incidence rate for all-cause-mortality ranged from 4.2 to 15.9 and was significantly lower in the Netherlands (IR, 4.2; 95 % CI, 2.2 to 7.6) compared to Scotland (IR, 15.9; 95 % CI, 10.9 to 22.6). No significant difference in the incidence rates between Austria (IR, 9.8; 95 % CI, 7.0 to 13.4) and Hungary (IR, 9.3; 95 % CI, 6.8 to 12.4) was found. Conclusion After adjustment for known risk factors, incidence rates of cardiovascular endpoints, as well as all-cause-mortality still vary significantly between four European countries. This may be due to manifold reasons. Further analysis of the national therapeutic practice pattern within the PROVALID cohort may provide additional information.

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Trend in incidence, first course of treatment, and survival in patients with glioblastoma.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e19178 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e19178-e19178

Author(s):

Eunyoung Yang ◽

Natalia Egorova ◽

Gil Moskowitz ◽

Nina A. Bickell

Keyword(s):

Incidence Rate ◽

Pediatric Population ◽

Standard Of Care ◽

Annual Percent Change ◽

Large Tumor ◽

Kaplan Meier ◽

Cox Proportional Hazard Models ◽

Adjusted Incidence Rate ◽

Changes Over Time ◽

Adjusted Incidence

e19178 Background: Glioblastoma (GBM) is the most common form of primary brain cancer and notoriously difficult to treat. Over the last 15 years, the population has been aging, yet, there are gaps in analysis of incidence of GBM associated with demographic changes. Further, several important treatment changes over time have led to 3 combined therapies becoming the standard of care since 2005, but their impact on GBM survival are not well established. Methods: The Surveillance, Epidemiology and End Results (SEER) database was analyzed from 2000-2015. We identified 30,955 GBM patients. We calculated the incidence rate and adjusted incidence rate using 2015’s population as a standard, then identified the trends in incidence and treatment using JoinPoint. Survival was analyzed with Kaplan-Meier and Cox proportional hazard models. Results: The incidence of GBM was highest among elderly (≥65yr), followed by adult (19-64yr) and pediatric population (≤18yr) (6.24, 1.64 and 0.10 per 100,000, respectively). The GBM incidence was significantly higher among white than black and other race (2.10 vs. 0.78 vs. 0.77 per 100,000; p < 0.001) and among males than females (2.12 vs. 1.46 per 100,000; p < 0.001). The incidence of GBM has increased from 1.63 to 1.96 (per 100,000) during this period with an annual percent change (APC) of 1.39 (p < 0.001). After adjusting for patient age, the APC was 0.72 (p < 0.001). Combination therapy has increased dramatically since 2000: from 29.3% to 60.9%. Those who underwent all three treatments had better overall survival than those who did not (p < 0.001) after adjusting for comorbidities and demographics. Median survival increased from 7 months (2000-2003) to 11 months (2012-2015) (p < 0.001). In the multivariable model, advanced age, stage, white race, and large tumor size were associated with worse survival, while combination treatment with improved survival (HR = 0.2; CL 0.22-0.24). Conclusions: While there appears to be a growth in the incidence of GBM, it is tempered by the aging of the population. Patients who underwent all three therapies had greater survival than those who did not. Efforts should focus on increasing the proportion of patients who undergo the standard care.

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