Impact of Smoking Status on Lung Cancer Characteristics and Mortality Rates between Screened and Non-Screened Lung Cancer Cohorts: Real-World Knowledge Translation and Education

This was a retrospective hospital-based cohort study of participants diagnosed with lung cancer in the lung cancer register database, and our goal was to evaluate the impact of smoking and screening status on lung cancer characteristics and clinical outcomes. According to the hospital-based lung cancer register database, a total of 2883 lung cancers were diagnosed in 2883 patients between January 2007 and September 2017, which were divided into four groups according to smoking and screening status. A comparison was performed in terms of clinical characteristics and outcomes of lung cancer between the four groups. For non-smokers, age, gender, screened status, tumor size, targeted therapy, and curative surgery were independent prognostic factors of overall survival for lung cancer subjects. However, screened status and gender were not significant prognostic factors for lung cancer survival in smokers with lung cancer. For the non-smoker group, about 4.9% of lung cancer subjects (N = 81) were detected by screening. However, only 0.97% of lung cancer subjects (N = 12) were detected by screening in smokers. This could be attributed to smokers’ negative attitudes and low socioeconomic status preventing LDCT lung cancer screening. In summary, our real-world data suggest that effectively encouraging smokers to be more willing to participate in lung cancer screening programs with screening allowance and educational training in the future is an important issue.

EP.FRI.745 Information Sustainability: SCR+: A bespoke module to optimise information flows around the Somerset Cancer Register to enhance the multidisciplinary cancer team process

Background Many surgeons work within multidisciplinary cancer teams. The Somerset Cancer Register (SCR) is a national reporting system for service performance which is in use in more than 100 NHS Trusts. However, the core system has not yet been optimised for MDT users or for the surfacing of clinical data for research and other uses. Methods SCR replaced our legacy cancer reporting system in 2014. Working with the SCR developers, we integrated our cellular pathology and imaging records with the SCR MDT outputs. We subsequently developed SCR+ to optimise workflows for MDT coordinators and information presentation to clinical users. Results Our HTML-enabled SCR+ software application displays all cancer patients by pathological type and year of presentation on dynamic histograms, for ease of visualisation and interaction. Every selected case is displayed in list order for each and every MDT meeting, with a fast hyperlink to our integral Lifelines EPR interface, to electronic pathology records back to 1990, and to our Breast Cancer Data System for relevant patients. Conclusions The SCR+ module transforms the access and visualisation of cancer workload across our Trust for all authorised MDT users, with appropriate data security. The agile programming methodology allowed us to build a sustainable cancer data system with further development potential. The product substantially enhances user experience, data recall and productivity over legacy systems. Close cooperation between clinically proficient IT teams and clinicians as the end consumers of digital health data systems yields significant operational benefits at pace and with very modest costs.

Structure of Oncological Pathology and Survival of Patients with Malignant Tumors of the Eye and Adnexa (C69) Taking into Account Sex, Age and Histological Characteristics (Population Study)

Objective. In February 2019, we completed work on creating a unified database of the population cancer registry of the NorthWestern Federal district of the Russian Federation. The development of data on the material of a large area significantly increases the reliability of the material under study, especially for RARE localities of malignant tumors, which include tumors of the eye and and adnexa.For the first time in Russia to present an analysis of the effectiveness of anti-cancer activities in relation to malignant tumors of the eye and adnexa (C69) at the Federal district level with calculations of 5-year survival rates of patients taking into account sex, age and histological structure of tumors.Methods. The development of the 5-year survival rate of patients with malignant tumors of the eye (C69) included information from the database created by us Population cancer register of all administrative territories of the North-Western Federal district of Russia for the period from 1999 to 2013, more than 1000 observations (1022).Results. The study revealed a positive dynamics of survival in patients of the North-Western Federal district of Russia with malignant tumors of the eye. The 5-year survival rate increased among males from 58.8 to 63.1 %, and among females from 64.7 to 69.6 %. A significant overestimation of the proportion of early stages among primary patients with malignant tumors of the eye and adnexa (C69) was found, which may be due to medical errors. Calculations of patient survival (with careful tracking of the deceased) allow us to get a more objective picture.Conclusion. Excellent achievements in the treatment of patients of advanced research centers and institutes can be welcomed only if similar successes are recorded at the population level and are available to all patients. Our in-depth development of population data in the Federal district confirmed the success in the treatment of patients with the malignant tumors of the eye and adnexa (C69), and the patterns we found first in the database of the Population cancer register of St. Petersburg, and now in the North-Western Federal district of the Russian Federation. Similar studies in other Federal districts could be an important component in the planning, monitoring and evaluation of anti-cancer measures in relation to the malignant tumors of the eye and adnexa (C69).

The state of oncology care in Russia. Kidney cancer (morbidity, mortality, index of accuracy, one-year and year-by-year mortality, histological structure). Part 1

Background. About 25,000 (2018 - 24,291) new cases of kidney cancer (KC) are registered in Russia annually, in the Northwestern Federal District of Russia in 2018 - 2504.Kidney cancer refers to localizations with a relatively low mortality rate. Mortality in the first year of observation is about 20 %. At the same time, an unfavorable trend in the dynamics of morbidity should be noted. Over the past 10 years, the annual growth rate for both sexes was 3.18%, mortality practically did not change, which indicates certain success in the treatment of patients.Materials and methods. The materials of the research were the monographs of IARC “Cancer on five continents”, reference books of the P.A. Herzen Moscow Oncology Research Institute and the database of the population cancer register of the Northwestern Federal District of the Russia own materials. Standard methods of statistical analysis were used.Results. The study revealed positive trends in the quality of registration of patients with kidney cancer, dynamics of mortality and survival of patients.Conclusion. The positive dynamics of the incidence rate of the population of Russia with kidney cancer has been established, and its place in the world community has been determined. Age-specific levels are close to those in the United States.Particular attention is paid to the need to use the Russian population cancer register database to obtain reliable data for an objective assessment of the activities of the oncological service in relation to kidney cancer.

Diagnostic codes of cancer in Skåne healthcare register: a validation study using individual-level data in southern Sweden

Background The Swedish healthcare is decentralised to 21 regions. Detailed information on all delivered care in the southernmost region, Skåne, is prospectively collected in the Skåne Healthcare Register (SHR). The data is updated daily and hence a good source for epidemiological studies. However, the diagnostic codes used to identify cancer patients in SHR have not yet been validated. Methods We conducted a validation study including 1,473,204 residents in Skåne region during 2005–2014, with at least one physical consultation in SHR. Newly diagnosed cancer from the Swedish Cancer Register was considered the ‘gold standard’ reference. We estimated the positive predictive value (PPV), sensitivity, and area under the curve (AUC) of a cancer diagnosis based on SHR by level of consultation, for any cancer, and for different cancer types. Results There were 61,693 cancers from the Swedish Cancer Register, and 87,650 cancers from SHR. The PPV of SHR-based diagnosis of any cancer was 63.76% (95% confidence interval (CI): 63.44–64.08%) with a sensitivity of 90.58% (95% CI: 90.35–90.81%). The AUC was 0.94, for any cancer. The measures of PPV, sensitivity and AUC varied across levels of care and were higher in specialized care than in primary care. The highest PPV was observed for specialist inpatient care in SHR (89.17, 95% CI 88.89–89.45%) whereas the highest sensitivity was observed for specialized outpatient care in SHR (86.39, 95%CI 86.12–86.66%). Robust validity was noted among most cancers, except for cancers of soft tissues, central nervous system and eye, and endocrine glands. Conclusions Our study supports that SHR is a valid and robust healthcare register for cancer diagnosis, with varying validities across levels of care and cancer types. This makes SHR a useful data source for cancer epidemiological studies, especially because the data covers the entire cancer care pathways without time lags for further linkage.

Population characteristics of colorectal cancer in the Ulyanovsk region according to the regional cancer register

Aim: to analyze the structure and changes of colorectal cancer (CRC) epidemiology in the Ulyanovsk region in 2005–2019 according to the regional cancer register.Materials and methods: the study is based on statistical data on the primary detection of CRC in the districts of the Ulyanovsk region (form No. 7) in 2005–2019. Standardized rates of morbidity and mortality were evaluated. Data on the number, gender and age of the regional population were obtained in Ulyanovsk State Statistics Service.Results: the incidence of CRC in the region increased by 1.51 times over the analyzed period (from 31.12 to 49.58 per 100 thousand people). From the total number of newly diagnosed CRC in 2019, the urban population was 25%, and the rural population — 75%. The incidence rates in the districts of the region were assessed. The highest morbidity in males was detected at the age of 60–64 years old, and it was 1.58 times higher than in females. In the adult population under 30 years old, only few cases of colorectal cancer were detected. The main histological type of tumors was adenocarcinoma. Poorly differentiated tumors accounted for about 3%. The highest age-standardized rates for rectal tumors were 10.1 and 12.8 per 100 thousand people in 2005 and 2019, respectively; for the recto sigmoid tumors — 0.9 and 2.3 per 100 thousand people; and for the anal cancer — 0.4 cases per 100 thousand people in 2019. The male/female ratio of deaths from CRC in 2019 was 1.005:1.000.Conclusion: there has been a trend to an increase in the incidence of colorectal cancer among the Ulyanovsk region population in the period from 2005 to 2019. We identified some areas of the region that significantly differ in the incidence of colorectal cancer.

Comments on the article Population characteristics of colorectal cancer in the Ulyanovsk region according to the regional cancer register

.

Trend Shifts in Age-Specific Incidence for In Situ and Invasive Cutaneous Melanoma in Sweden

Background: The incidence of invasive cutaneous melanoma (CM) is increasing in Sweden. The aim was to present age- and sex-specific trends of the age-standardised incidence and the average annual percentage change (AAPC) for in situ and invasive CM. Methods: Joinpoint regression models were used to analyse data from the Swedish Cancer Register and the Swedish Melanoma Registry 1997–2018 (N = 35,350 in situ CM; 59,932 CM). Results: The AAPC of CM for women was 4.5 (4.1–5.0; p < 0.001) for the period 1997–2018. For men, the APCC was 4.2 (3.0–5.4; p < 0.001), with a significantly higher annual percentage change (APC) for the period 2000–2018 (5.0; 4.6–5.4; p < 0.001) compared to 1997–1999. An increasing annual incidence of CM ≤ 0.6 mm and 0.7 mm Breslow tumour thickness was found for men with a significant incidence shift for the period 2006–2015, respectively. Similarly for women, with a significantly higher APC for CM ≤ 0.6 mm from 2005. The incidence of intermediate thick CM (2.1–4.0 mm) has not increased since 2011. The incidence of CM > 4.0 mm has been increasing among both sexes, with a significantly lower APC among women from 2005. Conclusions: The incidence of in situ and low-risk CM ≤ 1.0 mm in tumour thickness has been rising among both sexes since the 2000s.