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Lee D, Yun HW, Kim N, Park J, Jung KW, Suh M, Shin DW. Exploring age-standardized cancer incidence rates and regional disparities: A retrospective cohort study of 8 major cancers in South Korea. Cancer Epidemiol 2024; 91:102594. [PMID: 38870624 DOI: 10.1016/j.canep.2024.102594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND We analyzed trends in cancer incidence and regional disparities of eight major types of cancer in Korea. METHODS This retrospective cohort study used the data of 17 cities/provinces from the Korea Central Cancer Registry (1999-2020) in South Korea. Age-standardized incidence rates (per 100,000 person-years), between-group variance (per 100,000 person-years)2, and annual percentage changes ( %) were calculated for the eight most common malignancies. Joinpoint regression was utilized to identify the points at which significant changes occur in cancer incidence or regional disparity trends over time to characterize these trends. RESULTS The incidence of stomach cancer decreased as regional disparity decreased and that of colorectal cancer initially increased but recently declined, showing fluctuations in regional disparity. The incidence and regional disparity in liver cancer decreased. The incidence of lung cancer remained stable, with reduced regional disparities. The incidence of breast cancer rose with increasing regional disparity, whereas the incidence of cervical cancer decreased, accompanied by decreased regional disparity. A significant increase in prostate cancer was found, with initially reduced regional disparities but later showed a resurgence. The incidence of thyroid cancer fluctuated alongside variations in regional disparities. CONCLUSION This study revealed cancer incidence and regional variations in each cancer type in Korea. More studies are needed to understand the underlying factors and potential interventions for reducing cancer incidence and addressing regional disparity.
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Affiliation(s)
- Dagyeong Lee
- Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea
| | | | - Nayeon Kim
- National Cancer Control Institute, National Cancer Center, Goyang-si, South Korea
| | - Juwon Park
- National Cancer Control Institute, National Cancer Center, Goyang-si, South Korea
| | - Kyu-Won Jung
- National Cancer Control Institute, National Cancer Center, Goyang-si, South Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang-si, South Korea.
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
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Smoothed Temporal Atlases of Age-Gender All-Cause Mortality in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14091072. [PMID: 28914783 PMCID: PMC5615609 DOI: 10.3390/ijerph14091072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/01/2017] [Accepted: 09/08/2017] [Indexed: 02/08/2023]
Abstract
Most mortality maps in South Africa and most contried of the sub-Saharan region are static, showing aggregated count data over years or at specific years. Lack of space and temporral dynamanics in these maps may adversely impact on their use and application for vigorous public health policy decisions and interventions. This study aims at describing and modeling sub-national distributions of age-gender specific all-cause mortality and their temporal evolutions from 1997 to 2013 in South Africa. Mortality information that included year, age, gender, and municipality administrative division were obtained from Statistics South Africa for the period. Individual mortality level data were grouped by three ages groups (0-14, 15-64, and 65 and over) and gender (male, female) and aggregated at each of the 234 municipalities in the country. The six age-gender all-cause mortality rates may be related due to shared common social deprivation, health and demographic risk factors. We undertake a joint analysis of the spatial-temporal variation of the six age-gender mortality risks. This is done within a shared component spatial model construction where age-gender common and specific spatial and temporal trends are estiamted using a hierarchical Bayesian spatial model. The results show municipal and temporal differentials in mortality risk profiles between age and gender groupings. High rates were seen in 2005, especially for the 15-64 years age group for both males and females. The dynamic geographical and time distributions of subnational age-gender all-cause mortality contribute to a better understanding of the temporal evolvement and geographical variations in the relationship between demographic composition and burden of diseases in South Africa. This provides useful information for effective monitoring and evaluation of public health policies and programmes targeting mortality reduction across time and sub-populations in the country.
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Sarakarn P, Suwanrungruang K, Vatanasapt P, Wiangnon S, Promthet S, Jenwitheesuk K, Koonmee S, Tipsunthonsak N, Chen SLS, Yen AMF, Chen THH. Joinpoint Analysis Trends in the Incidence of Colorectal Cancer in Khon Kaen, Thailand (1989 – 2012). Asian Pac J Cancer Prev 2017; 18:1039-1043. [PMID: 28547938 PMCID: PMC5494213 DOI: 10.22034/apjcp.2017.18.4.1039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective: This study focused on recent changes in the incidence of colorectal cancer (CRC) in Khon Kaen,
Thailand. Methods: Data for CRC over the period 1989 to 2012 from the population-based cancer registry of Khon
Kaen province were employed. Age-standardized incidence rates (ASR) were calculated and classified into 4 age-groups
for comparison. Joinpoint regression analysis was used to detect changes in trends among each line segment and an
overall line was generated, whether increasing or decreasing, with annual percent change (APC) and average annual
percent change (AAPC). Results: There were 3,364 CRC cases included in the analysis, 72.2% histological confirmed
and 53.5% in men. Trends of ASRs generally demonstrated gradual increase over the period 1989 to 2012. For those
aged under 45 or 50 years there was slight overall increase, with a somewhat zigzag pattern. From joinpoint analysis,
the trends of all aged groups were found to be increasing among both men and women: aged 45 years and older group
AAPC=3.40, 2.30 and 3.90, respectively); aged 50 years and older group AAPC=2.90, 2.20 and 3.40; aged under 45
years AAPC=6.30, 6.00 and 6.90; and aged under 50 years (AAPC=5.70, 3.20 and 5.70. Conclusions: ASRs for CRC
have been gradually increasing in the northeast region of Thailand. Future studies should consider the subsite distribution.
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Affiliation(s)
- Pongdech Sarakarn
- Institute of Epidemiology and Prevention Medicine, College of Public Health, National Taiwan University, Taiwan.
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Schootman M, Chien L, Yun S, Pruitt SL. Explaining large mortality differences between adjacent counties: a cross-sectional study. BMC Public Health 2016; 16:681. [PMID: 27484009 PMCID: PMC4970203 DOI: 10.1186/s12889-016-3371-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 07/26/2016] [Indexed: 11/10/2022] Open
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Moghadamyeghaneh Z, Alizadeh RF, Phelan M, Carmichael JC, Mills S, Pigazzi A, Zell JA, Stamos MJ. Trends in colorectal cancer admissions and stage at presentation: impact of screening. Surg Endosc 2015; 30:3604-10. [PMID: 26541735 DOI: 10.1007/s00464-015-4662-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 10/28/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) incidence is rising among patients under age 50. As such, we set out to determine the proportion of CRC-related hospital admissions and distribution of colon cancer by stage in different age groups. METHODS The NIS database for 2002-2012 was used to investigate trends of colorectal cancer resection by age, and the ACS NSQIP database for 2012-2013 was used to investigate contemporary stage at diagnosis for colon cancer in different age groups. RESULTS A total of 1,198,421 patients were admitted to a hospital with a diagnosis of CRC and captured by the NIS database. Although the number of hospitalized CRC patients decreased from 2002 to 2012, the observed decrease was predominant in patients older than 65 years (P < 0.01) and in colon cancer compared to rectal cancer patients (P < 0.01). The proportion of patients younger than 65 years increased from 32.8 % in 2002 to 41.1 % in 2012, and the proportion of patients under age 50 increased from 9 to 12 %. In the NSQIP database, the age <50 group also had a significantly higher proportion of advanced disease (stage III/IV) compared to patients age 50 and older (62.3 vs. 47.5 %, P < 0.01). In 2012, it was observed that most patients with rectal cancer were younger than 65 years (55.8 %). CONCLUSION There was a steady decrease in the number of hospitalized patients with colorectal cancer during the last decade, primarily attributable to a decrease in the older than 65 years age patients and colon cancer patients. The proportion of hospitalized patients age <50 is rising. In addition, patients younger than 50 years were more likely to have advanced disease compared to older patients.
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Affiliation(s)
- Zhobin Moghadamyeghaneh
- Department of Surgery, University of California Irvine, School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA
| | - Reza Fazl Alizadeh
- Department of Surgery, University of California Irvine, School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA
| | - Michael Phelan
- Department of Statistics, University of California, Irvine, CA, USA
| | - Joseph C Carmichael
- Department of Surgery, University of California Irvine, School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA
| | - Steven Mills
- Department of Surgery, University of California Irvine, School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA
| | - Alessio Pigazzi
- Department of Surgery, University of California Irvine, School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA
| | - Jason A Zell
- Chao Family Comprehensive Cancer Center, Division of Hematology/Oncology, Department of Medicine, University of California Irvine, School of Medicine, Orange, CA, USA
| | - Michael J Stamos
- Department of Surgery, University of California Irvine, School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA.
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Pruitt SL, Davidson NO, Gupta S, Yan Y, Schootman M. Missed opportunities: racial and neighborhood socioeconomic disparities in emergency colorectal cancer diagnosis and surgery. BMC Cancer 2014; 14:927. [PMID: 25491412 PMCID: PMC4364088 DOI: 10.1186/1471-2407-14-927] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 11/26/2014] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Disparities by race and neighborhood socioeconomic status exist for many colorectal cancer (CRC) outcomes, including screening use and mortality. We used population-based data to determine if disparities also exist for emergency CRC diagnosis and surgery. METHODS We examined two emergency CRC outcomes using 1992-2005 population-based U.S. SEER-Medicare data. Among CRC patients aged ≥66 years, we examined racial (African American vs. white) and neighborhood poverty disparities in two emergency outcomes defined as: 1) newly diagnosed CRC or 2) CRC surgery associated with: obstruction, perforation, or emergency inpatient admission. Multilevel logistic regression (patients nested in census tracts) analyses adjusted for sociodemographic, tumor, and clinical covariates. RESULTS Of 83,330 CRC patients, 29.1% were diagnosed emergently. Of 55,046 undergoing surgery, 26.0% had emergency surgery. For both outcomes, race and neighborhood poverty disparities were evident. A significant race by poverty interaction (p < .001) was noted: poverty rate was associated with both outcomes among African Americans, but not whites. Compared to whites in low poverty (<10%) neighborhoods, African Americans in high poverty (≥20%) neighborhoods had increased odds of emergency diagnosis (AOR: 1.50, 95% CI: 1.38-1.63) and surgery (AOR: 1.63, 95% CI: 1.47-1.81). CONCLUSIONS Emergency CRC outcomes are associated with high poverty residence among African Americans in this population-based study, potentially contributing to observed disparities in CRC morbidity and mortality. Targeted efforts to increase CRC screening among African Americans living in high poverty neighborhoods could reduce preventable disparities.
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Affiliation(s)
- Sandi L Pruitt
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd E1, 410D Dallas, TX, USA.
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Etxeberria J, Ugarte MD, Goicoa T, Militino AF. Age- and sex-specific spatio-temporal patterns of colorectal cancer mortality in Spain (1975-2008). Popul Health Metr 2014; 12:17. [PMID: 25136264 PMCID: PMC4131489 DOI: 10.1186/1478-7954-12-17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 06/25/2014] [Indexed: 01/04/2023] Open
Abstract
In this paper, space-time patterns of colorectal cancer (CRC) mortality risks are studied by sex and age group (50-69, ≥70) in Spanish provinces during the period 1975-2008. Space-time conditional autoregressive models are used to perform the statistical analyses. A pronounced increase in mortality risk has been observed in males for both age-groups. For males between 50 and 69 years of age, trends seem to stabilize from 2001 onward. In females, trends reflect a more stable pattern during the period in both age groups. However, for the 50-69 years group, risks take an upward trend in the period 2006-2008 after the slight decline observed in the second half of the period. This study offers interesting information regarding CRC mortality distribution among different Spanish provinces that could be used to improve prevention policies and resource allocation in different regions.
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Affiliation(s)
- Jaione Etxeberria
- Department of Statistics and O. R., Public University of Navarre, Campus de Arrosadia, Pamplona, Navarre, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - María Dolores Ugarte
- Department of Statistics and O. R., Public University of Navarre, Campus de Arrosadia, Pamplona, Navarre, Spain
| | - Tomás Goicoa
- Department of Statistics and O. R., Public University of Navarre, Campus de Arrosadia, Pamplona, Navarre, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Pamplona, Spain
| | - Ana F Militino
- Department of Statistics and O. R., Public University of Navarre, Campus de Arrosadia, Pamplona, Navarre, Spain
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Stimpson JP, Pagán JA, Chen LW. Reducing racial and ethnic disparities in colorectal cancer screening is likely to require more than access to care. Health Aff (Millwood) 2013; 31:2747-54. [PMID: 23213159 DOI: 10.1377/hlthaff.2011.1290] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Colorectal endoscopy, an effective screening intervention for colorectal cancer, is recommended for people age fifty or older, or earlier for those at higher risk. Rates of colorectal endoscopy are still far below those recommended by the US Preventive Services Task Force. This study examined whether factors such as the supply of gastroenterologists and the proportion of the local population without health insurance coverage were related to the likelihood of having the procedure, and whether these factors explained racial and ethnic differences in colorectal endoscopy. We found evidence that improving access to health care at the county and individual levels through expanded health insurance coverage could improve colorectal endoscopy use but might not be sufficient to reduce racial and ethnic disparities in colorectal cancer screening. Policy action to address these disparities will need to consider other structural and cultural factors that may be inhibiting colorectal cancer screening.
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Affiliation(s)
- Jim P Stimpson
- Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, Nebraska, USA.
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Chien LC, Schootman M, Pruitt SL. The modifying effect of patient location on stage-specific survival following colorectal cancer using geosurvival models. Cancer Causes Control 2013; 24:473-84. [PMID: 23306551 PMCID: PMC3617359 DOI: 10.1007/s10552-012-0134-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 12/17/2012] [Indexed: 10/27/2022]
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer death in the US, and stage at diagnosis is the primary prognostic factor. To date, the interplay between geographic place and individual characteristics such as cancer stage with CRC survival is unexplored. We used a Bayesian geosurvival statistical model to evaluate whether the spatial patterns of CRC survival at the census tract level varies by stage at diagnosis (in situ/local, regional, distant), controlling for patient characteristics, surveillance test use, and treatment using linked 1991-2005 SEER-Medicare data of patients ≥ 66 years old in two US metropolitan areas. The spatial pattern of survival varied by stage at diagnosis for both cancer sites and registries. Significant spatial effects were identified in all census tracts for colon cancer and the majority of census tracts for rectal cancer. Geographic disparities appeared to be highest for distant-stage rectal cancer. Compared to those with in situ/local stage in the same census tracts, patients with distant-stage cancer were at most 7.73 times and 4.69 times more likely to die of colon and rectal cancer, respectively. Moreover, frailty areas for CRC at in situ/local stage more likely have a higher relative risk at regional stage, but not at distant stage. We identified geographic areas with excessive risk of CRC death and demonstrated that spatial patterns varied by both cancer type and cancer stage. More research is needed to understand the moderating pathways between geographic and individual-level factors on CRC survival.
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Affiliation(s)
- Lung-Chang Chien
- Department of Internal Medicine, Division of Health Behavior Research, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 6700, St. Louis, MO 63108, USA.
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MYER PARVATHIA, MANNALITHARA AJITHA, SINGH GURKIRPAL, LADABAUM URI. Proximal and distal colorectal cancer resection rates in the United States since widespread screening by colonoscopy. Gastroenterology 2012; 143:1227-1236. [PMID: 22841786 PMCID: PMC4524880 DOI: 10.1053/j.gastro.2012.07.107] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 07/03/2012] [Accepted: 07/19/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND & AIMS Screening decreases colorectal cancer (CRC) incidence and mortality. Colonoscopy has become the most common CRC screening test in the United States, but the degree to which it protects against CRC of the proximal colon is unclear. We examined US trends in rates of resection for proximal vs distal CRC, which reflect CRC incidence, in the context of national CRC screening data, before and since Medicare's 2001 decision to pay for screening colonoscopy. METHODS We used the Nationwide Inpatient Sample, the largest US all-payer inpatient database, to estimate age-adjusted rates of resection for distal and proximal CRC, from 1993 to 2009, in adults. Temporal trends were analyzed using Joinpoint regression analysis. RESULTS The rate of resection for distal CRC decreased from 38.7 per 100,000 persons (95% confidence interval [CI], 35.4-42.0) to 23.2 per 100,000 persons (95% CI, 20.9-25.5) from 1993 to 2009, with annual decreases of 1.2% (95% CI, 0.1%-2.3%) from 1993 to 1999, followed by larger annual decreases of 3.8% (95% CI, 3.3%-4.3%) from 1999 to 2009 (P < .001). In contrast, the rate of resection for proximal CRC decreased from 30.0 per 100,000 persons (95% CI, 27.4-32.5) to 22.7 per 100,000 persons (95% CI, 20.6-24.7) from 1993 to 2009, but significant annual decreases of 3.1% (95% CI, 2.3%-4.0%) occurred only after 2002 (P < .001). Rates of resection for CRC decreased for adults ages 50 years and older, but increased for younger adults. CONCLUSIONS These findings support the hypothesis that population-level decreases in rates of resection for distal CRC are associated with screening, in general, and that implementation of screening colonoscopy, specifically, might be an important factor that contributes to population-level decreases in rates of resection for proximal CRC.
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Affiliation(s)
- PARVATHI A. MYER
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California,Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - AJITHA MANNALITHARA
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California,Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - GURKIRPAL SINGH
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California,Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - URI LADABAUM
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California,Department of Medicine, Stanford University School of Medicine, Stanford, California
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Siegel RL, Ward EM, Jemal A. Trends in colorectal cancer incidence rates in the United States by tumor location and stage, 1992-2008. Cancer Epidemiol Biomarkers Prev 2012; 21:411-6. [PMID: 22219318 DOI: 10.1158/1055-9965.epi-11-1020] [Citation(s) in RCA: 148] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Results from case-control studies outside the United States have been conflicted about the efficacy of colonoscopy for reducing cancer risk in the right colon. To contribute to this discourse from an alternative perspective, we analyzed high-quality surveillance data to report on recent trends in population-based colorectal cancer incidence rates by tumor location in the United States. METHODS Data from cancer registries in the Surveillance, Epidemiology, and End Results Program were analyzed to examine colorectal cancer incidence trends from 1992 through 2008 among individuals aged ≥ 50 years (n = 267,072). Joinpoint regression analysis was used to quantify annual percent change in age-standardized rates by tumor location and disease stage. RESULTS Incidence rates for right-sided colon tumors decreased annually by 2.6% (95% CI: 2.0-3.2) since 1999 in men and 2.3% (CI: 1.6-3.0) since 2000 in women, after remaining stable during the previous seven/eight years. Incidence rates for left-sided tumors were generally decreasing from 1992 to 2008 in both sexes. Beginning in 1999/2000, substantial, almost identical annual declines occurred for late-stage disease in both the right and left colon: 3.9% (CI: 3.1-4.8) and 4.2% (CI: 3.5-4.9), respectively, in men; and 3.3% (CI: 2.5-4.1) and 3.3% (CI: 2.8-3.8) in women. CONCLUSION Large declines in the incidence of right-sided colon tumors among individuals 50 years and older began around 2000. IMPACT Increased colonoscopy utilization during the past decade may have contributed to a reduction in risk for cancers in both the right and left colorectum in the United States.
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Affiliation(s)
- Rebecca L Siegel
- Corresponding Author: Rebecca L. Siegel, Intramural Research, American Cancer Society, 250 Williams Street, NW, 6D123, Atlanta, GA 30303, USA.
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Paskett ED. Cancer health [corrected] disparities: moving from why they occur to how they can be prevented. J Clin Oncol 2011; 30:354-6. [PMID: 22184382 DOI: 10.1200/jco.2011.39.5947] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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