Incidence and survival analyses for occult lung cancer between 2004 and 2015: a population-based study

Background This study aimed to investigate the incidence and long-term survival outcomes of occult lung cancer between 2004 and 2015. Methods A total of 2958 patients were diagnosed with occult lung cancer in the 305,054 patients with lung cancer. The entire cohort was used to calculate the crude incidence rate. Eligible 52,472 patients (T1-xN0M0, including 2353 occult lung cancers) were selected from the entire cohort to perform survival analyses after translating T classification according to the 8th TNM staging system. Cancer-specific survival curves for different T classifications were presented. Results The crude incidence rate of occult lung cancer was 1.00 per 100 patients, and it was reduced between 2004 and 2015 [1.4 per 100 persons in 2004; 0.6 per 100 persons in 2015; adjusted risk ratio = 0.437, 95% confidence interval (CI) 0.363–0.527]. In the survival analysis, there were 2206 death events in the 2353 occult lung cancers. The results of the multivariable analysis revealed that the prognoses with occult lung cancer were similar to patients with stage T3N0M0 (adjusted hazard ratio = 1.054, 95% CI 0.986–1.127, p = 0.121). Adjusted survival curves presented the same results. In addition, adjusted for other confounders, female, age ≤ 72 years, surgical treatment, radiotherapy, adenocarcinoma, and non-squamous and non-adenocarcinoma non-small cell carcinoma were independent protective prognostic factors (all p < 0.05). Conclusions Occult lung cancer was uncommon. However, the cancer-specific survival of occult lung cancer was poor, therefore, we should put the assessment of its prognoses on the agenda. Timely surgical treatment and radiotherapy could improve survival outcomes for those patients. Besides, we still need more research to confirm those findings.

Syndromic surveillance of female sexually transmitted infections in primary care: a descriptive study in Monastir, Tunisia, 2007─2017

Background Sexually Transmitted Infections (STIs) are a public health problem, especially for reproductive-age women. The aim of this study was to determine the incidence and trend of STIs during 11 years in Tunisia (2007–17). Methods We conducted a descriptive study including all women with curable STIs (chlamydia, gonorrhea, syphilis and trichomoniasis) diagnosed with the syndromic approach in all basic health care centers of the Governorate of Monastir (Tunisia) from 2007 to 2017. Syndromes included, Pelvic Pain (PP), Vaginal Discharge (VD) and Genital Ulceration (GU). Results We analyzed 40,388 episodes of curable STIs with a crude incidence rate and age standardized incidence rate of 1393 (95% Confidence Interval (CI); 1348–1438) / 100,000 Person Year (PY) and 1328 (95%CI; 1284–1372) /100,000 PY respectively. The incidence rate showed a positive trend over 11 years for all age groups and syndromes. VD was the most common syndrome with a crude incidence rate of 1170/100,000 PY. For all syndromes, women aged 20 to 39 were the most affected age group (p < 0.001). Conclusion In conclusion, the incidence rate of STIs episodes among women diagnosed with the syndromic approach was high, consistent with the global evidence. Focusing on reviewing STIs surveillance system in low and middle-income countries could allow the achievement of the ending of STIs epidemics by 2030.

1375Age-standardization to world population and under-estimation of oral cancer burden

Background Age-standardization is common for adjustment of unequal population in different ages as it can influence cancer incidence. However, for planning healthcare services (including screening), one needs absolute magnitude since everyone needs intervention. This study assessed the effect of age-standardization on understanding the global differentials in magnitude of oral cancer. Methods Data on cancer incidence rates of oral cancers for 2008-2012, was obtained from the website of international agency for research on cancer for all 334 population-based cancer registries. Scatter plots were prepared between age-standardized and crude incidence rates to assess the ratio between them according to proportion of old people for all countries. Areas with high occurrence of oral cancer were identified. Results The ratio between age-standardized and crude incidence rate was &gt;1 in countries with high proportion of older population (high-development-index countries), indicating an artificial widening of gap between incidence rates between countries due to age-standardization. Six areas had higher crude incidence rate among men than India. Based on the published estimates, the per-unit-population burden in Europe was 6.3% higher than India, while in USA it was merely 12.5% lower than India. Conclusions The perception of low burden of oral cancer in high-economy countries is artificial, brought about by common practice of age-standardization. Key messages Organization of oral cancer screening activities by countries with resources and expertise will provide much needed knowledge on its natural history and efficacy of control strategies.

Participation Rate, Risk Factors, and Incidence of Colorectal Cancer in the Screening Program Among the Population Covered by the Health Centers in Arak, Iran

Background: Colorectal cancer (CRC) is among the most common and preventable cancers, the incidence and risk factors of which are different in various populations. Objectives: The present study aims at assessing incidence rate, risk factors, and symptoms of CRC among the populations aged 50 to 70 years old covered by the health centers in Arak, as well as evaluating participation rate in the CRC screening program. Methods: The present cross-sectional study was conducted from 2016 to 2019 among all of the individuals aged 50 to 70 years old, who were referred to rural, urban, and suburban health centers in Arak for CRC screening, and their data were recorded in the Sib system. The participation rate, risk factors (family and individual history of CRC, colorectal adenoma, and inflammatory bowel disease), symptoms (lower gastrointestinal bleeding, constipation with or without diarrhea, and weight loss), and crude incidence rate of CRC were calculated in the age range. Results: The mean (SD) age of the CRC was 59.72 (5.56) years. In addition, the individuals’ participation rate in the program was about 44.2%, which was more among women (55.5%) and villagers (93.7%). Most subjects complained of constipation in the last month and CRC family history. The CRC crude incidence rates were 35.93 (95% CI: 25.55 - 50.54), 40.96 (95% CI: 29.81 - 56.29), 43.76 (95% CI: 32.22 - 59.43), and 52.84 (95% CI: 40.05 - 69.71) per 100000 individuals during 2016, 2017, 2018, and 2019, respectively. Conclusions: The participation rate in the CRC screening program was low, and the trend of the cancer crude incidence rate increased among the populations aged 50 to 70 years. Finally, informing about the recognition of the risk factors and symptoms of cancer, as well as the timely referral for screening was considered essential.

Clinical Significance of Ventricular Tachyarrhythmias in Patients Undergoing Valve Replacement: A Nationwide Population-Based Study

Background: The clinical significance and outcomes of ventricular tachyarrhythmias (VTa) in patients undergoing valve replacement have rarely been reported.Objective: This study aimed to investigate the incidence and outcome of VTa after surgical valve replacement.Methods: We conducted a population-based retrospective cohort study using data obtained from the Taiwan National Health Insurance Research Database. In total, 10,212 patients were selected after 1:1 propensity-score matching based on the type of prosthetic valve used (mechanical vs. bioprosthetic). Various outcomes during long-term follow-up were analyzed.Results: After a median follow-up period of 59.6 months, the crude incidence rate of VTa after surgical valve replacement was 4.8/1,000 person-years, and the cumulative incidence of VTa persistently increased after surgery. Furthermore, the occurrences of VTa after valve replacement significantly increased the risk of cardiovascular (CV) death (P &lt; 0.001, HR 1.67, 95% CI 1.41–1.96), stroke- (P &lt; 0.001, HR 1.66, 95% CI 1.37–2.01), atrial fibrillation- (P &lt; 0.001, HR 2.80, 95% CI 2.42–3.24), and congestive heart failure-related hospitalization (P &lt; 0.001, HR 2.61, 95% CI 2.30–2.95). Among patients with VTa, all-cause mortality (P = 0.001, HR 0.49, 95% CI 0.32–0.75) and CV death (P = 0.047, HR 0.58, 95% CI 0.34–0.99) in those with implantable cardioverter-defibrillator (ICD) implantation were lower than those without.Conclusion: The crude incidence rate of VTa after surgical valve replacement was 4.8/1,000 person-years, and the cumulative incidence of VTa persistently increased during follow-up. The presence of VTa after surgical valve replacement increases hospitalization and CV death, while ICD implantation reduced the mortality rate in these patients.

A nationwide study of Chlamydia trachomatis infections in Denmark during the COVID-19 pandemic

Objectives: COVID-19 policies have been employed in Denmark since March 2020. We examined whether COVID-19 restrictions had an impact on Chlamydia trachomatis infections compared with 2018 and 2019. Methods: This retrospective nation-wide Danish observational study was performed using monthly incidences of laboratory confirmed chlamydia cases and number of tests, obtained from nation-wide surveillance data. Additionally, Oxford COVID-19 Government Response Tracker data, and Google COVID-19 Community Mobility Reports were used to contextualise the behavioural adaptions seen as a result of COVID-19 policies. Testing rates were compared using Poisson regression and test positivity rates were compared using logistic regression. Results: The crude incidence rate (IR) of laboratory confirmed chlamydia infections was reduced to 66.5 per 105 during the first (March-April 2020) lockdown period as compared to 88.3 per 105 in March-April 2018-2019, but the testing rate was also reduced (Rate ratio 0.72 95% CI 0.71-0.73), whereas the odds ratio for a positive test between the two periods was 0.98 (95% CI 0.96-1.00). The period of eased COVID 19 restrictions (May-December 2020) and the second lockdown period (December 2020-March 2021) were characterised by marginally increased crude IRs, while the number of tests performed, and test positivity rates returned very close to the levels seen in 2018-2019. These results were independent of sex, age group, and geographical location. Conclusion: The first Danish COVID-19 lockdown resulted in a reduction in the number of chlamydia tests performed and a consequent reduction in the number of laboratory-identified cases. This period was followed by a return of testing and test positivity close to the level seen in 2018-2019. Altogether the Danish COVID-19 restrictions have had negligible effects on laboratory confirmed C. trachomatis transmission.

RELATIONSHIP OF HEMOBLASTOSIS INCIDENCE RATES WITH THE DENSITY OF RADIOACTIVE CONTAMINATION IN THE REGIONS OF BELARUS

Introduction. Sustainable development of territories affected by the Chernobyl disaster, require a number of managerial decisions, to reduce the level of radiophobia and psycho-emotional stress in society. Aim. To study the relationship between the indicators of the incidence of hemoblastosis with the density of contamination of territories with radioactive elements. Material and methods. An ecological population epidemiological study based on the calculation of the correlation coefficients of the incidence rates of hemoblastosis with the density of radioactive contamination. Results. There is no connection between the incidence of hemoblastosis and the density of radioactive contamination of territories. A statistically significant risk of multiple myeloma is observed in areas with a 137Cs contamination density of 1.0-4.99 Ci/km2. There was a statistically significant strong (r> 0.95) correlation between the crude incidence rate and standardized by age, sex and place of residence incidence ratio. The presence of strong correlations between these indicators give the possibility to use crude incidence rate instead of SIR in the analysis of morbidity by rayons. Conclusions. No correlation was found between the incidence of hemoblastosis and the density of radioactive contamination.

Future Incidence of Malignant Mesothelioma in South Korea: Updated Projection to 2038

Malignant mesothelioma (MM) is a cancer that is largely caused by exposure to asbestos. Although asbestos is no longer used in South Korea, the incidence of MM continues to increase due to its long latent period. We aimed to update the previous prediction of MM incidence until 2038. We predicted the incidence of MM over the next 20 years (2019–2038) in South Korea using Møller’s age–period–cohort (APC) model and a Poisson regression model based on asbestos consumption. The APC model predicted that the crude incidence rate would increase sharply in men and slowly in women. Despite the sex discrepancy in the rate of increase, the incidence rate for both sexes is expected to continue increasing until 2038. In the Poisson model, the crude incidence rate was predicted to increase continuously until 2038, and far more cases of MM were predicted to occur compared with the results of the APC model. When compared with actual incidence data, the APC model was deemed more suitable than the Poisson model. The APC model predicted a continuous increase over the next 20 years with no peak, suggesting that the incidence of MM will continue to rise far into the future.

The Incidence of Nasopharyngeal Carcinoma in Pahang State of Malaysia from 2012 to 2017

Background: Nasopharyngeal carcinoma (NPC) is the fifth most common cancer among Malaysians. While several studies have reported the trend of NPC in other states in Malaysia, no studies have reported the trend of NPC in Pahang state. This study was designed to report the number and distribution of newly diagnosed NPC cases in Pahang. Methods: NPC cases that were diagnosed between 2012 and 2017 in two referral hospitals in Pahang were traced. The crude incidence rate (CR) and age-standardised rate (ASR) were calculated to investigate the NPC incidence. Results: There were 143 new cases of NPC reported from the two hospitals. The mean age at diagnosis was 52.0 ± 13.7 years old. The majority of cases involved males (74.1%) with a male to female ratio of 2.9:1. Chinese males were found to have the highest incidence with a mean ASR of 4.7 per 100,000 population. Overall, the mean ASR for Pahang was 2.4 per 100,000 population for males and 0.9 per 100,000 population for females. Conclusion: The total number of NPC cases reveals an increasing trend from 2012 to 2014 and then a slightly decreasing trend from 2015 to 2017. The incidence of NPC in Pahang was intermediate in males and low in females.