scholarly journals Flexible Modeling of Net Survival and Cure by AML Subtype and Age: A French Population-Based Study from FRANCIM

2021 ◽  
Vol 10 (8) ◽  
pp. 1657
Author(s):  
Morgane Mounier ◽  
Gaëlle Romain ◽  
Mary Callanan ◽  
Akoua Alla ◽  
Olayidé Boussari ◽  
...  
Keyword(s):  
Population Based ◽  
Future Research ◽  
French Population ◽  
Monocytic Leukemia ◽  
Younger Patients ◽  
Younger Women ◽  
Net Survival ◽  
Flexible Modeling ◽  
Acute Myelomonocytic Leukemia ◽  
Sex Disparity

With improvements in acute myeloid leukemia (AML) diagnosis and treatment, more patients are surviving for longer periods. A French population of 9453 AML patients aged ≥15 years diagnosed from 1995 to 2015 was studied to quantify the proportion cured (P), time to cure (TTC) and median survival of patients who are not cured (MedS). Net survival (NS) was estimated using a flexible model adjusted for age and sex in sixteen AML subtypes. When cure assumption was acceptable, the flexible cure model was used to estimate P, TTC and MedS for the uncured patients. The 5-year NS varied from 68% to 9% in men and from 77% to 11% in women in acute promyelocytic leukemia (AML-APL) and in therapy-related AML (t-AML), respectively. Major age-differenced survival was observed for patients with a diagnosis of AML with recurrent cytogenetic abnormalities. A poorer survival in younger patients was found in t-AML and AML with minimal differentiation. An atypical survival profile was found for acute myelomonocytic leukemia and AML without maturation in both sexes and for AML not otherwise specified (only for men) according to age, with a better prognosis for middle-aged compared to younger patients. Sex disparity regarding survival was observed in younger patients with t-AML diagnosed at 25 years of age (+28% at 5 years in men compared to women) and in AML with minimal differentiation (+23% at 5 years in women compared to men). All AML subtypes included an age group for which the assumption of cure was acceptable, although P varied from 90% in younger women with AML-APL to 3% in older men with acute monoblastic and monocytic leukemia. Increased P was associated with shorter TTC. A sizeable proportion of AML patients do not achieve cure, and MedS for these did not exceed 23 months. We identify AML subsets where cure assumption is negative, thus pointing to priority areas for future research efforts.

Conditional net survival: Relevant prognostic information for colorectal cancer survivors. A French population-based study

2015 ◽  
Vol 47 (7) ◽  
pp. 597-601 ◽  
Author(s):  
Antoine Drouillard ◽  
Anne-Marie Bouvier ◽  
Fabien Rollot ◽  
Jean Faivre ◽  
Valérie Jooste ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Survivors ◽  
Population Based ◽  
French Population ◽  
Prognostic Information ◽  
Population Based Study ◽  
Net Survival ◽  
Colorectal Cancer Survivors

scholarly journals The association between varying levels of palliative care involvement on costs during terminal hospitalizations in Canada from 2012 to 2015

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarina R. Isenberg ◽  
Christopher Meaney ◽  
Peter May ◽  
Peter Tanuseputro ◽  
Kieran Quinn ◽  
...  
Keyword(s):  
Palliative Care ◽  
Metastatic Cancer ◽  
Estimating Equation ◽  
Population Based ◽  
Future Research ◽  
Chronic Obstructive ◽  
Discharge Abstract Database ◽  
High Involvement ◽  
Hospitalization Costs ◽  
The Cost

Abstract Background Inpatient palliative care is associated with lower inpatient costs; however, this has yet to be studied using a more nuanced, multi-tiered measure of inpatient palliative care and a national population-representative dataset. Using a population-based cohort of Canadians who died in hospital, our objectives were to: describe patients’ receipt of palliative care and active interventions in their terminal hospitalization; and examine the relationship between inpatient palliative care and hospitalization costs. Methods Retrospective cohort study using data from the Discharge Abstract Database in Canada between fiscal years 2012 and 2015. The cohort were Canadian adults (age ≥ 18 years) who died in hospital between April 1st, 2012 and March 31st, 2015 (N = 250,640). The exposure was level of palliative care involvement defined as: medium-high, low, or no palliative care. The main measure was acute care costs calculated using resource intensity weights multiplied by the cost of standard hospital stay, represented in 2014 Canadian dollars (CAD). Descriptive statistics were represented as median (IQR), and n(%). We modelled cost as a function of palliative care using a gamma generalized estimating equation (GEE) model, accounting for clustering by hospital. Results There were 250,640 adults who died in hospital. Mean age was 76 (SD 14), 47% were female. The most common comorbidities were: metastatic cancer (21%), heart failure (21%), and chronic obstructive pulmonary disease (16%). Of the decedents, 95,450 (38%) had no palliative care involvement, 98,849 (38%) received low involvement, and 60,341 (24%) received medium to high involvement. Controlling for age, sex, province and predicted hospital mortality risk at admission, the cost per day of a terminal hospitalization was: $1359 (95% CI 1323: 1397) (no involvement), $1175 (95% CI 1146: 1206) (low involvement), and $744 (95% CI 728: 760) (medium-high involvement). Conclusions Increased involvement of palliative care was associated with lower costs. Future research should explore whether this relationship holds for non-terminal hospitalizations, and whether palliative care in other settings impacts inpatient costs.

scholarly journals Does access to care play a role in liver cancer survival? The ten-year (2006–2015) experience from a population-based cancer registry in Southern Italy

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Walter Mazzucco ◽  
Francesco Vitale ◽  
Sergio Mazzola ◽  
Rosalba Amodio ◽  
Maurizio Zarcone ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Access To Care ◽  
Cancer Registry ◽  
Health Care Services ◽  
Cancer Survival ◽  
Developed Countries ◽  
Population Based ◽  
Easy Access ◽  
Net Survival ◽  
Poor Access

Abstract Background Hepatocellular carcinoma (HCC) is the most frequent primary invasive cancer of the liver. During the last decade, the epidemiology of HCC has been continuously changing in developed countries, due to more effective primary prevention and to successful treatment of virus-related liver diseases. The study aims to examine survival by level of access to care in patients with HCC, for all patients combined and by age. Methods We included 2018 adult patients (15–99 years) diagnosed with a primary liver tumour, registered in the Palermo Province Cancer Registry during 2006–2015, and followed-up to 30 October 2019. We obtained a proxy measure of access to care by linking each record to the Hospital Discharge Records and the Ambulatory Discharge Records. We estimated net survival up to 5 years after diagnosis by access to care (“easy access to care” versus “poor access to care”), using the Pohar-Perme estimator. Estimates were age-standardised using International Cancer Survival Standard (ICSS) weights. We also examined survival by access to care and age (15–64, 65–74 and ≥ 75 years). Results Among the 2018 patients, 62.4% were morphologically verified and 37.6% clinically diagnosed. Morphologically verified tumours were more frequent in patients aged 65–74 years (41.6%), while tumours diagnosed clinically were more frequent in patients aged 75 years or over (50.2%). During 2006–2015, age-standardised net survival was higher among HCC patients with “easy access to care” than in those with “poor access to care” (68% vs. 48% at 1 year, 29% vs. 11% at 5 years; p < 0.0001). Net survival up to 5 years was higher for patients with “easy access to care” in each age group (p < 0.0001). Moreover, survival increased slightly for patients with easier access to care, while it remained relatively stable for patients with poor access to care. Conclusions During 2006–2015, 5-year survival was higher for HCC patients with easier access to care, probably reflecting progressive improvement in the effectiveness of health care services offered to these patients. Our linkage algorithm could provide valuable evidence to support healthcare decision-making in the context of the evolving epidemiology of hepatocellular carcinoma.

scholarly journals 50P Early breast cancer in women aged 35 years or younger: A French population-based case control-matched analysis

2021 ◽  
Vol 32 ◽  
pp. S42
Author(s):  
O. Dufour ◽  
G. Houvenaeghel ◽  
J-M. Classe ◽  
M. Cohen ◽  
C. Faure ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Population Based ◽  
Case Control ◽  
French Population

scholarly journals Outdoor Air Pollution and Depression in Canada: A Population-Based Cross-Sectional Study from 2011 to 2016

2021 ◽  
Vol 18 (5) ◽  
pp. 2450
Author(s):  
Ashley K. Dores ◽  
Gordon H. Fick ◽  
Frank P. MacMaster ◽  
Jeanne V. A. Williams ◽  
Andrew G. M. Bulloch ◽  
...  
Keyword(s):  
Air Pollution ◽  
Fine Particulate Matter ◽  
Canadian Community Health Survey ◽  
Population Based ◽  
Cross Sectional Study ◽  
Future Research ◽  
Outdoor Air ◽  
Cross Sectional ◽  
Outdoor Air Pollution ◽  
Environmental Health Research

To assess whether exposure to increased levels of outdoor air pollution is associated with psychological depression, six annual iterations of the Canadian Community Health Survey (n ≈ 127,050) were used to estimate the prevalence of a major depressive episode (2011–2014) or severity of depressive symptoms (2015–2016). Survey data were linked with outdoor air pollution data obtained from the Canadian Urban Environmental Health Research Consortium, with outdoor air pollution represented by fine particulate matter ≤2.5 micrometers (μm) in diameter (PM2.5), ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2). Log-binomial models were used to estimate the association between outdoor air pollution and depression, and included adjustment for age, sex, marital status, income, education, employment status, urban versus rural households, cigarette smoking, and chronic illness. No evidence of associations for either depression outcomes were found. Given the generally low levels of outdoor air pollution in Canada, these findings should be generalized with caution. It is possible that a meaningful association with major depression may be observed in regions of the world where the levels of outdoor air pollution are greater, or during high pollution events over brief time intervals. Future research is needed to replicate these findings and to further investigate these associations in other regions and populations.

Correlates of Physical Activity Participation in Community-Dwelling Older Adults

2010 ◽  
Vol 18 (4) ◽  
pp. 375-389 ◽  
Author(s):  
Christy Haley ◽  
Ross Andel
Keyword(s):  
Physical Activity ◽  
Population Based ◽  
Male Gender ◽  
Community Dwelling ◽  
Physical Activity Participation ◽  
Functional Health ◽  
Activity Participation ◽  
Future Research ◽  
Research Attention ◽  
Exercise Participation

The authors examined factors related to participation in walking, gardening or yard work, and sports or exercise in 686 community-dwelling adults 60–95 years of age from Wave IV of the population-based Americans’ Changing Lives Study. Logistic regression revealed that male gender, being married, and better functional health were associated with greater likelihood of participating in gardening or yard work (p < .05). Male gender, better functional health, and lower body-mass index were independently associated with greater likelihood of walking (p < .05). Increasing age, male gender, higher education, and better functional health were associated with greater likelihood of participating in sports or exercise (p < .05). Subsequent analyses yielded an interaction of functional health by gender in sport or exercise participation (p = .06), suggesting a greater association between functional health and participation in men. Gender and functional health appear to be particularly important for physical activity participation, which may be useful in guiding future research. Attention to different subgroups may be needed to promote participation in specific activities.

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