Development of cancerogenic risk index maps for the territory of Vladikavkaz

В последние годы наблюдается значительный рост численности населения, которому соответствуют ускоренные темпы индустриализации. Это сопровождается всё более значительным загрязнением окружающей среды тяжелыми металлами. Наибольший вклад в загрязнение окружающей среды Республики Северная Осетия – Алания долгие годы вносила горнодобывающая промышленность, в последнее же время к ней, в качестве не менее весомого источника загрязнения присоединились нестационарные источники. Загрязнение тяжелыми металлами создает серьезную опасность для здоровья населения и окружающей среды из-за их токсичной природы. Цель исследования. Разработка карт пространственного распределения загрязняющих веществ является основой в оценке уровня загрязнения окружающей среды. Цель настоящего исследования – разработка карт индекса канцерогенного риска и установление его взаимосвязи с онкозаболеваемостью населения. Методы исследования. В процессах создания карт используются методы интерполяции, так как количество проб и измерений содержания вредных веществ в той или иной среде, как правило, весьма ограничено. Согласно зарубежным исследованиям, для большинства наиболее часто используемых методов интерполяции обеспечивается одинаково высокая точность. В настоящей работе при расчёте индексов канцерогенного риска использовался метод обратного взвешивания расстояний. Результаты работы Отобран материал по заболеваемости населения злокачественными образованиями по различным районам г. Владикавказа. Основной удельный вес вновь зарегистрированных злокачественных новообразований приходится на возрастные группы свыше 60 лет. Анализ онкозаболеваемости показал, что в тех районах г. Владикавказа, где уровень загрязнения окружающей среды выше, выше и показатели онкозаболеваемости. Проведен расчёт индекса риска для здоровья населения при воздействии химических веществ загрязняющих окружающую среду. По всем исследуемым показателям наблюдается значительное превышение предельно допустимых значений, за исключением ртути. Полученные данные о высоком уровне канцерогенного риска согласуются с высоким уровнем онкологической заболеваемости на территории города, что говорит о тесной взаимосвязи заболеваемости и индекса канцерогенного риска. In recent years, there has been a significant increase in the population, which is matched by the accelerated rate of industrialization. This is accompanied by increasingly significant pollution of the environment with heavy metals. For many years, the mining industry has made the greatest contribution to the environmental pollution of the Republic of North Ossetia – Alania, non-stationary sources have recently joined as an equally significant source of pollution. Heavy metal pollution poses a serious threat to public health and the environment due to its toxic nature. Aim. The development of maps of the spatial distribution of pollutants is the basis for assessing the level of environmental pollution. The aim of this study is to develop maps of the carcinogenic risk index and to establish its relationship with the incidence of cancer in the population. Methods. In the process of creating maps, interpolation methods are used, since the number of samples and measurements of the content of harmful substances in a particular environment is usually very limited. According to foreign studies, for most of the commonly used interpolation methods, equally high accuracy is provided. In the present work, we used the method of the inverse weighting of distances for calculating the indices of carcinogenic risk. Results. The material on the incidence of malignant neoplasms in the population in various districts of Vladikavkaz was selected. The main share of newly registered malignant neoplasms falls on the age groups over 60 years old. The analysis of cancer morbidity showed that in those areas of Vladikavkaz where the level of environmental pollution is higher, the indicators of cancer morbidity are also higher. The calculation of the risk index for public health under the influence of chemical substances polluting the environment has been carried out. For all the studied indicators, there is a significant excess of the maximum permissible values, with the exception of mercury. The obtained data on the high level of carcinogenic risk is consistent with the high level of cancer incidence in the city; it indicates a close relationship between the incidence and the carcinogenic risk index.

Cancer Morbidity and Computed Tomography: “After” and “Due to” Challenge

The article discusses the problem of carcinogenic risk assessment in the context of relationship with diagnostic radiation resulted from Computed Tomography (CT). The study aimed to evaluate the possible long-term carcinogenic effects after the exposure to a low dose of diagnostic radiation, appeared within a decade after the 1st CT scan. Information on patients examined using CT in the District Hospital of Kasli (KDH) has been derived from the CT archives since 2009 when the first CT examinations has been performed in the KDH. The data were linked to local Cancer registry, the Death registry, and the “CT Registry” database (CTDB) to obtain the information on vital status, the cause of death, cancer morbidity and CT examinations outside KDH, respectively. 275 CT examinations of 246 patients have been recorded to the data file (KDH cluster). To the end of the study, 46 cases of malignant tumours (MT) have been accumulated in the study group. The average observation time was 6.5 years (90% CI 6.2-6.8). The distribution of cancers among patients exposed to CT has been shown retrospectively through the date of birth of patient to December, 31, 2018. The cases of MT diagnosed prior to 1st CT examination have been excluded from the analyses. Cancer-related conditions stated before the date of 1stCT examination have been accounted. The cumulative cancer incidence after the exposure to CT, adjusted for predisposed conditions in the study group was 4.8%. The study results have been compared with the results of the LSS cohort study to assess the expected excess cancer morbidity. The data obtained in the study provide the information for a comprehensive epidemiological assessment of long-term effects related to diagnostic radiation exposure in the Ozyorsk Computed Tomography Cohort (OCTC study). Doi: 10.28991/SciMedJ-2021-0304-3 Full Text: PDF

Retrospective analysis of cancer morbidity among patients after computed tomography

Cancer morbidity among patients examined using computed tomography within 10 years follow-up period depending on various factors has been retrospectively analyzed. Information on Ozyorsk residents examined at the Kasli District Hospital was retrospectively collected. The data collection period started in 2009 when the first computed tomography examination has been performed in the X-ray department of Kasli District Hospital, and ended by December 31, 2018. The data obtained in the study were linked to the local Cancer registry, the Death registry, and the “CT Registry” database to receive information about the vital status, cancer morbidity and CT examinations performed outside the Kasli District Hospital. Cumulative incidence has been accounted in terms of predisposed conditions associated with cancer, cancer diagnoses stated before the date of the first CT examination and CT-confirmed malignancy cases. As a result of the study, information on 275 examinations of 246 residents of the Ozyorsk urban district has been derived. By the end of the observation period, 46 cases of malignant tumors were accumulated in the study group. The average time from 1st CT to the end of follow-up was 6.5 years. The distribution of carcinogenic effects among patients examined using CT has been shown retrospectively from the date of birth to the date of the end of follow-up. The cumulative cancer incidence adjusted for predisposing conditions has been compared with the LSS data. No epidemiological data were found on the relationship between the detected cases of malignant tumors and the diagnostic radiation from CT scans. The data obtained in the study provide information on the long-term oncological effects among Ozyorsk residents examined using CT as a source of additional information for a comprehensive assessment of the low dose effects associated with diagnostic exposure in the Ozyorsk Computed Tomography Cohort study.

Lack of Salivary Long Non-Coding RNA XIST Expression Is Associated with Increased Risk of Oral Squamous Cell Carcinoma: A Cross-Sectional Study

Studies have shown that there is a disparity between males and females in south-east Asia with regard to oral cancer morbidity. A previous study found that oral cancer tissue showed loss of heterozygosity of the X-linked lncRNA XIST gene. We suggest that XIST may play an important role in oral cancer morbidity when associated with sex. Saliva contains proteins and RNAs that are potential biomarkers for the diagnosis of diseases. This study investigated salivary XIST expression and the correlation to clinical–pathological data among oral squamous cell carcinoma patients. Salivary XIST expression was only observed in females, and a high proportion of females with OSCC lack salivary lncRNA XIST expression (88%). The expression showed no correlation with alcohol consumption, betel quid chewing, or cigarette smoking habits. People lacking salivary lncRNA XIST expression had a significantly increased odds ratio of suffering from OSCC (OR = 19.556, p < 0.001), particularly females (OR = 33.733, p < 0.001). The ROC curve showed that salivary lncRNA XIST expression has acceptable discrimination accuracy to predict the risk of OSCC (AUC = 0.73, p < 0.01). Lack of salivary lncRNA XIST expression was associated with an increased risk of OSCC. We provided an insight into the role of salivary lncRNA XIST as a biomarker to predict the morbidity of OSCC.

Socioeconomic disparities in cancer incidence and mortality in England and the impact of age-at-diagnosis on cancer mortality

Background We identify socioeconomic disparities by region in cancer morbidity and mortality in England for all-cancer and type-specific cancers, and use incidence data to quantify the impact of cancer diagnosis delays on cancer deaths between 2001–2016. Methods and findings We obtain population cancer morbidity and mortality rates at various age, year, gender, deprivation, and region levels based on a Bayesian approach. A significant increase in type-specific cancer deaths, which can also vary among regions, is shown as a result of delay in cancer diagnoses. Our analysis suggests increase of 7.75% (7.42% to 8.25%) in female lung cancer mortality in London, as an impact of 12-month delay in cancer diagnosis, and a 3.39% (3.29% to 3.48%) increase in male lung cancer mortality across all regions. The same delay can cause a 23.56% (23.09% to 24.30%) increase in male bowel cancer mortality. Furthermore, for all-cancer mortality, the highest increase in deprivation gap happened in the East Midlands, from 199 (186 to 212) in 2001, to 239 (224 to 252) in 2016 for males, and from 114 (107 to 121) to 163 (155 to 171) for females. Also, for female lung cancer, the deprivation gap has widened with the highest change in the North West, e.g. for incidence from 180 (172 to 188) to 272 (261 to 282), whereas it has narrowed for prostate cancer incidence with the biggest reduction in the South West from 165 (139 to 190) in 2001 to 95 (72 to 117) in 2016. Conclusions The analysis reveals considerable disparities in all-cancer and some type-specific cancers with respect to socioeconomic status. Furthermore, a significant increase in cancer deaths is shown as a result of delays in cancer diagnoses which can be linked to concerns about the effect of delay in cancer screening and diagnosis during the COVID-19 pandemic. Public health interventions at regional and deprivation level can contribute to prevention of cancer deaths.

P–355 Cancer diagnosis among patients with recurrent pregnancy loss: a cohort study

Study question Is unexplained recurrent pregnancy loss (RPL) related to long term cancer morbidity? Summary answer Recurrent unexplained pregnancy loss patients showed lower cancer morbidity. This trend was significant in the secondary aborters and in a sub-analysis for gynecological cancers. What is known already The association between infertility and cancer was studied, but has scarcely been studied in RPL; One study reported a higher incidence of breast and uterine cancers, while another found no association. Immune dysfunction is a possible cause of ‘unexplained RPL’; RPL patients have an increased number of toxic natural killer cells (NKs) in both peripheral blood and decidua. The immune system is also involved in the recognition of cancer cells, potentially leading to effective killing. It is possible that the NK populations in RPL are capable of a better response towards cancer cells in the uterine environment and related organs. Study design, size, duration A retrospective cohort study comparing RPL patients and patients with normal deliveries presenting between 1990 –2010 and followed up until 2018. Participants/materials, setting, methods The RPL (exposed) group consisted of patients with 3 or more losses between 5–24 weeks. The comparison (unexposed) group included women who gave birth, and were not listed in the registry of RPL patients. Matching was based on maternal age and year of delivery, which was matched to the date of admission to the RPL clinic. Patients’ data were cross-linked to the national cancer registry. Kaplan-Meier survival curves were used to compare cancer incidence. Main results and the role of chance The RPL group comprised of 937 RPL patients, compared to 4685 patients with a live birth. The mean follow up time was 16.3 ±5.3 years for RPL cases and 15.9 ± 4.9 for the comparison group. Groups were compared in terms of lifetime risk, post-admission risk and according to cancer type. In a Univariate analysis, the life time risk for cancer was 5.3% (49/937) among RPL patients and 6.8% (317/4685) in the comparison group (p = 0.08). Survival analysis showed the same trend - a lower cancer morbidity in RPL patients (p = 0.06). The low cancer morbidity was more prominent, reaching statistical significance in secondary RPL patients (p = 0.05) , but not in primary RPL (p = 0.4). Breast cancer was the most common tumor, but was neither more nor less common in RPL than in the comparison group. Gynecological cancers, however, were significantly less common in RPL patients: 0.3% (3/937) compared to 1.3% (60/4685) in the comparison group (p = 0.01). After adjustment for maternal age the odds ratio for gynecological cancer was 0.247 (p = 0.018, 95% CI 0.077–0.791) and significantly represented in the survival analysis (p = 0.01). Limitations, reasons for caution There was no access to BMI and smoking status. Patients were followed for a mean period of 16 years; cancer may present later than 16 years. Wider implications of the findings: Unexplained RPL is assumed to have an immunological basis. Our study may provide an indirect support for hyper-responsive immunological mechanisms in RPL patients. Further research is needed to deepen our understanding of the underlying mechanisms and possibly to facilitate treatment options. Trial registration number Not applicable