Adaptive Robust Estimators to Handle Missing Values in Estimati ng Tumor Stage Distributions in Population-Based Cancer Registrati on

Abstract Background Hepatocellular carcinoma is one of few cancers with rising incidence and mortality in the United States. Little is known about disease presentation and outcomes across the rural-urban continuum. Methods Using the population-based SEER registry, we identified adults with incident hepatocellular carcinoma between 2000–2016. Urban, suburban and rural residence at time of cancer diagnosis were categorized by the Census Bureau’s percent of the population living in non-urban areas. We examined association between place of residence and overall survival. Secondary outcomes were late tumor stage and receipt of therapy. Results Of 83,368 cases, 75.8%, 20.4%, and 3.8% lived in urban, suburban, and rural communities, respectively. Median survival was 7 months (IQR 2–24). All stage and stage-specific survival differed by place of residence, except for distant stage. In adjusted models, rural and suburban residents had a respective 1.09-fold (95% CI = 1.04–1.14, p < .001) and 1.08-fold (95% CI = 1.05–1.10, p < .001) increased hazard of overall mortality as compared to urban residents. Furthermore, rural and suburban residents had 18% (OR = 1.18, 95% CI 1.10–1.27, p < .001) and 5% (OR = 1.05, 95% CI = 1.02–1.09, p = .003) higher odds of diagnosis at late stage and were 12% (OR = 0.88, 95% CI = 0.80–0.94, p < .001) and 8% (OR = 0.92, 95% CI = 0.88–0.95, p < .001) less likely to receive treatment, respectively, compared to urban residents. Conclusions Residence in a suburban and rural community at time of diagnosis was independently associated with worse indicators across the cancer continuum for liver cancer. Further research is needed to elucidate the primary drivers of these rural-urban disparities.

Download Full-text

The Natural History and Outcomes of the Patients with Carcinosarcoma Involving Kidney and Renal Pelvis

Advances in Urology ◽

10.1155/2011/693964 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Jue Wang ◽

Fen Wei Wang ◽

Anne Kessinger

Keyword(s):

Natural History ◽

Renal Pelvis ◽

Histological Grade ◽

Tumor Stage ◽

Population Based ◽

Age At Diagnosis ◽

Cancer Specific Survival ◽

Entire Cohort ◽

Undifferentiated Histology ◽

Almost All

Background. The objective of this paper was to examine the epidemiology, natural history, and prognostic factors of carcinosarcoma of the kidney and renal pelvis (CSKP) using population-based registry.Patients and Methods. Forty-three patients with CSKP, diagnosed between January 1973 and December 2007, were identified from the national Surveillance, Epidemiology, and End Results (SEER) database and reviewed.Results. 79% of all patients with known SEER stage were classified as having regional or distant stage; almost all the patients with known histology grade had poorly or undifferentiated histology. The median cancer specific survival was 6 months (95% CI 4–9). The 1-year cancer-specific survival rate for entire cohort was 30.2%. There were no differences in terms of age at diagnosis, histological grade, tumor stage on presentation, and frequency of nephrectomy between carcinosarcoma of kidney (CSK) or renal pelvis (CSP). In multivariate analysis, age at diagnosis, tumor stage, and year of diagnosis were found to be significant predictors for cancer-specific survival.Conclusion. CSKP commonly presented as high-grade, advanced stage disease, and was associated with a poor prognosis regardless of location.

Download Full-text

Imputation of missing values of tumour stage in population-based cancer registration

BMC Medical Research Methodology ◽

10.1186/1471-2288-11-129 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 51

Author(s):

Nora Eisemann ◽

Annika Waldmann ◽

Alexander Katalinic

Keyword(s):

Missing Values ◽

Population Based ◽

Cancer Registration ◽

Tumour Stage

Download Full-text

Comparison of adenocarcinoma (ACA) and squamous cell carcinoma (SCC) of the uterine cervix: A population-based epidemiologic study of 60,000 women in Brazil.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.1587 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 1587-1587

Author(s):

Angelica Noguelra Rodrigues ◽

Luiz Claudio Santos Thuler ◽

Anke Bergmann ◽

Suzana Sales de Aguiar ◽

Carlos Gil Moreira Ferreira

Keyword(s):

Uterine Cervix ◽

Epidemiologic Study ◽

Tumor Stage ◽

Population Based ◽

Response To Treatment ◽

Inadequate Response ◽

Chi Square ◽

Cervical Cancers ◽

Increased Risk ◽

Screening Strategies

1587 Background: Most cancers of the uterine cervix are SCC, but the relative and absolute incidence of ACA has risen in recent years, particularly in younger patients, and ACA now accounts for about 20% of invasive cervical cancers in screened populations worldwide. However, the developing world, with sub-optimally screened women, accounts for more than 80% of incident cervical cancers. Our objective was to compare epidemiological, clinical characteristics, and treatment outcome of ACA with those of SCC of the cervix, with respect to ethnic group, age and stage at diagnosis, and pattern of response to first treatment in a sub-optimally screened population. Methods: Data of cervical cancer patients with SCC and ACA (adenosquamous + adenocarcinoma) treated from 2000 through 2009 were obtained from the Brazilian Hospital Cancer Register databases. Summary odds ratios and chi-square tests were estimated. Results: A total of 60,883 patients were analyzed: 54,425 (89.4%) cases of SCC, and 6,458 (10.6%) of ACA. Compared to ACA, the SCC cohort were younger (49.37 x 51.83 years, p<0.001), more frequently black (58.1% x 49.2%, p<0.001), presented higher degree of illiteracy (22.7 x 16.1%, p<0.001), and alcohol (13 x 9.8%, p<0.001) and tobacco dependence (41.5 x 31%, p<0.001). Tumor stage at the time of diagnosis was also significantly different (p<0.01). Considering prognostic factors, in both subtypes, more than 60% of the patients were stage II or inferior and ACA was associated with a significantly increased risk of inadequate response after the first course of treatment (crude OR=1.14 CI95%=1.07-1.21; adjusted OR=0.94 CI95%=0.87-1.01) and of death (crude OR=1.26 CI95%=1.15-1.38; adjusted OR=1.1 CI95%=1.00-1.23). Conclusions: Differences between ACA and SCC were found in age at diagnosis, extent of disease and ethnic distribution. In spite of these differences, the inadequate response to treatment seems to be mainly the result of more advanced stage, rather than cell type. Screening strategies with higher sensitivity are necessary, and irrespectively of histological subtype, quality of treatment must be improved in developing countries.

Download Full-text

The impact of obstetric interventions and complications on women’s satisfaction with childbirth - a population based cohort study including 16000 women.

10.21203/rs.2.13381/v2 ◽

2019 ◽

Author(s):

Maja Falk ◽

Marie Nelson ◽

Marie Blomberg

Keyword(s):

Cohort Study ◽

Postpartum Hemorrhage ◽

Missing Values ◽

Population Based ◽

Vas Score ◽

Individualized Care ◽

Emergency Cesarean ◽

Total Prevalence ◽

Study Population ◽

The Impact

Abstract Background: As a quality marker and a tool for benchmarking between units, a visual analogue scale (VAS) (ranging from 1 to 10) to estimate woman’s satisfaction with childbirth was introduced in 2014. This study aimed to assess how obstetric interventions and complications affected women’s satisfaction with childbirth. Methods: A retrospective cohort study including 16775 women with an available VAS score who gave birth between January 2016 and December 2017. VAS score, maternal and obstetric characteristics were obtained from electronic medical records and crude and adjusted odds ratios (aOR) were calculated. Results: The total prevalence of dissatisfaction with childbirth (VAS 1-3) was 5.7%. The main risk factors for dissatisfaction with childbirth were emergency cesarean section, aOR 3.98 95% confidence interval (CI) 3.27-4.86, postpartum hemorrhage ³2000 ml, aOR 1.85 95%CI 1.24-2.76 and Apgar score <7 at five minutes, aOR 2.95 95%CI 1.95-4.47. The amount of postpartum hemorrhage showed a dose-response relation to dissatisfaction with childbirth. Moreover, labor induction, instrumental vaginal delivery, and obstetric anal sphincter injury were significantly associated with women´s dissatisfaction with childbirth. A total number of 4429/21204 (21%) women giving birth during the study period () had missing values on VAS. A comparison of characteristics between women with and without a recorded VAS score was performed. There were statistically significant differences in maternal age and maternal BMI between the study population and excluded women due to missing values on VAS. Moreover, 64% of the women excluded were multiparas, compared to 59% in the study population. Conclusions: Obstetric interventions and complications, including emergency cesareans section and postpartum hemorrhage, were significantly related to dissatisfaction with childbirth. Such events are common and awareness of these associations might lead to a more individualized care of women during and after childbirth.

Download Full-text

Changing trends of incidence and prognosis of thyroid carcinoma

Nuklearmedizin ◽

10.1055/a-0859-7454 ◽

2019 ◽

Vol 58 (02) ◽

pp. 86-92 ◽

Cited By ~ 2

Author(s):

Jamshid Farahati ◽

Uwe Mäder ◽

Elena Gilman ◽

Rainer Görges ◽

Ines Maric ◽

...

Keyword(s):

Thyroid Cancer ◽

Lymph Node ◽

Distant Metastases ◽

Tumor Stage ◽

Lymph Node Involvement ◽

Population Based ◽

Management Algorithm ◽

Node Involvement ◽

T1 And T2 ◽

Lower Franconia

Abstract Aim to evaluate the time trend of epidemiology of follicular cell derived thyroid cancer (TC) based on data from a well documented cancer registry. Methods Population based data on TC from Lower Franconia (LF), Germany, within 1981 and 2015 were analysed to estimate the regional epidemiology of TC. The incidence was assessed in 5-year-intervals for gender, histology, and tumor stage. Results Incidence of TC solely attributable to papillary TC (PTC) doubled mainly in T1- and T2-stages within the evaluation period from 4.5 to 8.7/100.000/y in females and 1.7 to 4.1/100.000/y in males. There was no significant change of follicular TC (FTC), whereas anaplastic TC (ATC) decreased in the same interval. The number of lymph-node metastases and T3-cases increased, while the frequency of T4-stage and distant metastases decreased. Increased incidences of T1- and T2-stages suggest an over-diagnosis. In contrast, increasing number of tumors at T3-stage and with lymph node involvement contradict the over-diagnosis as the only reason for rising incidence. Declining of T4-stages in spite of increasing of T3-stages and N1-cases indicates the value of timely detection and treatment of TC. In accordance, reduced incidence of advanced cancers with M1-stage and ATC cases promote our current management of TC. Conclusion Timely diagnosis and adequate risk-adopted treatment of thyroid cancer reduce the frequency of high-risk cases with distant metastases and the possible protracted dedifferentiation of TC to anaplastic features. Our analyses support the management algorithm in thyroid cancer according to the recent guidelines of German Nuclear Medicine Society.

Download Full-text

A population-based study on the quality of life for cancer patients as reported in a tumor registry follow-up

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.8594 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 8594-8594

Author(s):

P. J. Novotny ◽

J. A. Sloan ◽

M. Frost ◽

M. Harris ◽

J. Huntington ◽

...

Keyword(s):

Quality Of Life ◽

Tumor Stage ◽

Population Based ◽

Healthy Population ◽

Tumor Registry ◽

Targeted Interventions ◽

Patient Reported ◽

Score Method

8594 Background: Between 1/96 and 3/00, 94,516 SF-36 or SF-12 Quality of Life (QOL) forms were sent to every patient on the Mayo Clinic tumor registry not seen at the clinic in the last year. This study is a descriptive summary of each patient’s first reported QOL score. Method: QOL scores were combined with tumor registry information about age, gender, tumor site, tumor stage, residence, and date of diagnosis. Responder versus non-responder characteristics were compared via Fisher’s exact tests and two-sample t-tests. Means and standard deviations were used to summarize the data. Patient reported scores and SF norms from a healthy population were compared using one sample t-tests. Results: Data were available on 28,166 patients (48,463 forms). Men were more likely to respond. More patients were male (56%) with a mean age of 66 and filled out their first SF form an average of 9 years after their initial diagnosis. Overall, mean physical and mental subscale scores were not clinically different from the age- and sex-adjusted SF normative data (Table). Within tumor sites, mental subscale scores were similar to the general population. Physical subscale scores were also approximately normal within each of the tumor sites. The exceptions were that patients with lung or musculoskeletal cancers tended to report lower physical scores than a healthy population. Conclusions: Patients responding to a tumor registry follow-up program reported QOL scores that were not clinically different from that of a healthy population. QOL deficits observed in patients with lung cancer and musculoskeletal cancers may indicate a need for targeted interventions specific for these cancer patient populations. [Table: see text] No significant financial relationships to disclose.

Download Full-text

Multiple primary tumors in patients with carcinosarcoma of bladder: A coincidence or an etiological association? A study of 221 carcinosarcoma of bladder cases

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e16138 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e16138-e16138

Author(s):

J. Wang ◽

F. Wang

Keyword(s):

Prognostic Factors ◽

Natural History ◽

Tumor Stage ◽

Population Based ◽

Primary Tumors ◽

Multiple Primary Tumors ◽

Number Of Patients ◽

Multiple Primary ◽

Primary Bladder ◽

Patient’S Outcome

e16138 Background: Carcinosarcoma of the bladder are rare; As a result, few studies of carcinosarcoma of the bladder have included sufficient number of patients to define their natural history and to determine the factors that impact survival. The objective of this study was to examine the epidemiology, natural history, and prognostic factors that affect the survival for carcinosarcoma of the bladder by using population-based registries. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program database (1973–2004) was used to identify cases of carcinosarcoma of the bladder by tumor site and histology codes. The association between clinical and demographic characteristics and survival of carcinosarcoma of the bladder was examined. Results: A total of 221 cases of histology confirmed carcinosarcoma of the bladder were identified, this account for approximately 0.11% of primary bladder tumors during same period. By using linked population files, we calculated the incidence of carcinosarcoma of the bladder as a rate 0.22 per 100,000 per year, age-adjusted to year 2000 U.S. standard population. Median age of all patients were 75 years (range 41–96). In about 40% of study population, more than one or multiple primary were also indentified. Majority of (212, 95.9 %) patients received cancer directed surgery. For survival analyses, we excluded the cases that were identified at autopsy or on the basis of death certificates only and the patients have more than one primary. Total 132 patients were included in survival analysis. The median overall survival for all cases was 9 months (range 6–12 months). In multivariate analysis, only tumor stage was found to be significant prognostic factors for disease-specific survival. Conclusions: Carcinosarcoma of the bladder are rare tumors that are challenging, the survival is poor even in patients underwent surgical resection. Better therapy is needed to improve patient's outcome. A significant fraction of carcinosarcoma patients are actually affected by multiple primary tumors, the potential association between carcinosarcoma and other neoplasms remain to be investigated. No significant financial relationships to disclose.

Download Full-text

Abstract P033: Alcohol and Incident Heart Failure among the Cohort of Swedish Men

Circulation ◽

10.1161/circ.129.suppl_1.p033 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Kirsten S Dorans ◽

Elizabeth Mostofsky ◽

Emily B Levitan ◽

Niclas Håkansson ◽

Alicja Wolk ◽

...

Keyword(s):

Heart Failure ◽

Alcohol Intake ◽

Missing Values ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Alcoholic Beverages ◽

History Of ◽

Incident Heart Failure ◽

Incident Cases

Background: The relationship between alcohol intake and incident heart failure (HF) is complex. Compared with no alcohol consumption, heavy alcohol intake is associated with higher HF risk whereas light or moderate consumption may be associated with lower risk. Methods: We analyzed 34,581 men 45-79 years old with no history of HF, diabetes mellitus or myocardial infarction (MI) who were participants in the population-based Cohort of Swedish Men study. We excluded former drinkers. At baseline, participants reported how frequently they consumed specific alcoholic beverages in the past year and other characteristics. HF was defined as hospitalization for or death from HF (primary diagnosis), ascertained by Swedish inpatient and cause-of-death records from January 1, 1998 to December 31, 2011. Due to missing values for two covariates, we used Markov chain Monte Carlo multiple imputation to simulate 5 complete datasets. We used Cox proportional hazards models to estimate rate ratios and 95% confidence intervals, adjusting for age, total energy intake, education, body mass index, physical activity, a dietary component score, cigarette smoking, marital status, family history of MI before age 60, history of hypertension and history of high cholesterol. Results: At baseline, mean age was 58.6 years. There were 1592 incident cases of HF over the follow-up period. Compared with never drinkers, the multivariable-adjusted rate of HF was 19% lower among men who drank <1 drink per week (rate ratio: 0.81, 95% confidence interval: 0.64, 1.04%). The multivariable-adjusted HF rate was similar among men who drank <1 drink per week and men who drank ≥1 drink per week. Conclusions: Light-to-moderate drinking is associated with lower rate of HF compared with never drinking, but the association was not statistically significant.

Download Full-text