A Retrospective Cohort Study of Lung Cancer Incidences and Epidemiological Analysis in Saudi Arabian Population from 2006–2016

Introduction: Lung cancer is one of the leading causes of cancer-related deaths worldwide, including in Saudi Arabia. In the past few decades, the incidence and mortality has increased considerably among the Saudi population. The incidence of lung cancer has increased more than 3% in less than two decades. The current study focuses on analyzing the frequency of diagnosed lung cancer cases, age-standardized incidence rate (ASIR), and crude incidence rate (CIR) classified by year of diagnosis, age group, and different administrative regions of Saudi Arabia, based on the Saudi cancer registry (SCR) for the period of 10 years from 2006–2016. Methodology: The present study is a cohort study that focuses on the epidemiological analysis of lung cancer cases. The statistical analysis was performed by t-test, sex ratio, Kruskal–Wallis, and descriptive statistics through SPSS version 20.0. Results: A total of 4530 lung cancer cases were reported from January 2006 to December 2016. Among males, the ASIR range was reported as 1.2 to 12.3 per 100,000 cases in different regions of Saudi Arabia. Moreover, among females, the ASIR range was reported from 0.2 to 3.1 per 100,000 cases in different regions of Saudi Arabia. Additionally, the overall age-standardized incidence sex ratio was 3.2 per 100,000 cases. The incidence of lung cancer increased with age as 23% was reported in the age group of more than 75 years. Conclusion: The study concludes a rise in crude incidence rates and ASIR for lung cancer among Saudi population. Among males, the Eastern region had the highest overall ASIR followed by Tabuk region, and, among females, the highest overall ASIR was reported in the Eastern region followed by Riyadh and the Northern region.

Bloodstream Infection Following Cardiac Valve Repair: A Population-Based Study

Background The aim of this study was to determine the incidence, epidemiology, and associated risk factors of bloodstream infection (BSI) in patients who had previously undergone cardiac valve repair. Methods A population-based study that included 7 counties in southeastern Minnesota using the expanded Rochester Epidemiology Project (e-REP) for adults (≥18 years) who underwent valve repair between 1 January 2010 and 31 December 2018 was conducted. Electronic health records were screened for development of BSI and infective endocarditis (IE) from the date of valve repair through 30 July 2020. A 1:4 nested case-control analysis was performed to determine an association, if any, of male sex, Charlson comorbidity index (CCI), and county of residence with BSI. Results A total of 335 patients underwent valve repair, of whom 28 (8.3%) developed an index case of BSI, with 14 episodes occurring within 1 year of surgery. The median age of patients with BSI was 70 years, and 79% were male. The crude incidence of BSI was 1671 cases per 100000 person-years and Escherichia coli was the most common pathogen. Case-control analysis demonstrated a significant correlation between CCI and incidence of BSI (P < .001). Only 4 (14.3%) patients developed IE concurrent with the onset of BSI, and no patients developed IE subsequent to BSI. Conclusions The crude incidence of BSI following valve repair was higher in our e-REP cohort than previous population-based studies, and half of the BSI cases occurred within 1 year of surgery. Patients with a higher CCI at baseline were at increased risk of subsequent BSI.

Increased risk of malignancy in patients with systemic lupus erythematosus: population-based cohort study in Korea

Background This study aimed to evaluate the crude incidence rates and relative risk of malignancy in Korean patients with SLE. Methods We conducted a retrospective nationwide cohort study using databases from the National Health Insurance Service in Korea. All prevalent SLE patients aged over 19 were identified from January 2012 to December 2014 and observed until the diagnosis of malignancy, death, or end of the study, December 2015. The crude incidence rates (IRs) and standardised incidence ratios (SIRs) of overall and site-specific malignancies in SLE patients were estimated. Results We identified 17,854 SLE patients and during the observation period (60,511 person-years [PYs]), 768 solid malignancies (126.9/10,000 PYs) and 68 haematologic malignancies (11.2/10,000 PYs) occurred in SLE patients. In SLE patients, breast and reproductive system and thyroid cancers occurred predominantly, followed by liver and colon cancers. The SIRs of overall, solid, and haematologic malignancies of SLE patients compared to the general population were 1.8 (95% confidence interval [CI] 1.6–1.9), 1.7 (95% CI 1.5–1.8), and 5.9 (95% CI 4.8–7.3), respectively. In solid malignancies, head and neck (2.7, 95% CI 1.1–4.2), bladder (2.4, 95% CI 1.1–3.8), liver (1.9, 95% CI 1.4–2.3), pancreas (1.9, 95% CI 1.3–2.6), lung (1.8, 95% CI 1.2–2.4), colon (1.7, 95% CI 1.3–2.2), thyroid (1.6, 95% CI 1.3–1.8) and breast and reproductive system (1.5, 95% CI 1.2–1.7) cancers are at increased risk in SLE patients. Conclusion An increased risk of haematologic and solid malignancies was observed in Korean patients with SLE compared to the general population.

Incidence of Primary Glaucoma in a Cohort of Nuclear Workers

Objective: The study was aimed to estimate primary glaucoma incidence in a cohort of nuclear workers occupationally exposed to ionizing radiation over prolonged periods.Materials and methods. The cohort considered in the study included workers of the Mayak Production Association. All glaucoma cases that were reported in the study worker cohort regardless of its type were identified using the medical and dosimetry database ‘Clinic’. Statistical analyses were performed to estimate non-standardized (crude) and standardized incidence rates for primary glaucoma. Standardization was carried out indirectly using age distribution for the whole cohort as an internal reference. Incidence rates were estimated per 1000 person-years in accordance with conventional medical statistics.Results. At the end of the follow-up period, 476 primary glaucoma cases were reported in the study worker cohort over 482,217 person-years of the follow-up. The standardized primary glaucoma incidence was estimated to be 1.00 ± 0.05 in males and 0.70 ± 0.07 in females. Crude primary glaucoma estimates in both males and females increased with the increasing attained age of the workers. Crude incidence rates in males were significantly higher than in females for age 50–69. The standardized primary glaucoma incidence in males was also significantly increased compared to females. The standardized primary glaucoma incidence rates were increasing throughout the period from 1960s to the end of the follow-up.

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.

Epidemiology of Parkinson’s Disease in Chile

<b><i>Introduction:</i></b> Parkinson’s disease (PD) is one of the most common neurodegenerative disorders. There is no epidemiological description of PD in Chile and not many descriptions in Latin America. This study aims to describe the incidence and prevalence of PD in Chile. <b><i>Methods:</i></b> The study group was the population on the public health system in Chile between 2010 and 2018 that were registered in the GES system as having PD. Crude and standardized prevalence and incidence were calculated with a 95% confidence interval. <b><i>Results:</i></b> 33,345 patients were found in the register as confirmed cases with PD. The crude incidence in 2018 was 23.7/100,000; the crude prevalence in 2018 was 160.7/100,000. The male-to-female ratio was 1.03. <b><i>Conclusion:</i></b> The prevalence and incidence observed in the Chilean population are consistent with studies from other countries.

Risk of hypertension in school-aged children with different parental risk: a longitudinal study from childhood to young adulthood

Background Although previous studies have shown the relationship between different parental factors and children’s blood pressure status, there is limited data on the cumulative effect of these factors. Considering parental socio-demographic, behavioral and cardio-metabolic characteristics, the current study aimed to distinguish parental risk clusters and their impact on the incidence of hypertension in school-age children over 13 years. Methods Parental characteristics of 1669 children, including age, education, employment, smoking, physical activity, metabolic syndrome (MetS), hypertension (HTN), weight status, and diabetes were considered to categorize parents into low and high-risk clusters. Crude incidence rates (per 10,000 person-years) of HTN in children were assessed in each maternal and paternal cluster. Using Cox proportional hazard model, results on the association between parental risk clusters and HTN incidence in children were reported in five different models. Results Mean age of children was 13.96 ± 2.89 years, and 51.2% (n = 854) were girls. MetS, HTN, and weight status were the most important factors distinguishing low and high-risk parental clusters, respectively. Crude incidence rates (per 10,000 person-years) of HTN were 86 (95% CI: 71–106) and 38 (95% CI, 29–52) in boys and girls, respectively. Moreover, incidence rates (per 10,000 person-years) of HTN were 50 (95% CI, 40–63) and 80 (95% CI, 64–102) in maternal low and high-risk clusters, respectively. The incidence rates (per 10,000 person-years) of HTN in paternal low and high-risk clusters were 53 (95% CI, 41–70) and 68 (95% CI, 56–84), respectively. Conclusion Our findings underscore the prognostic value of maternal characteristics in predicting the incidence of HTN in their offspring. The current results could be valuable in planning related programs to prevent hypertension in similar communities.

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.