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García-Alfonso P, Vera R, Aranda E, Élez E, Rivera F. Delphi consensus for the third-line treatment of metastatic colorectal cancer. Clin Transl Oncol 2024; 26:1429-1437. [PMID: 38411748 PMCID: PMC11108914 DOI: 10.1007/s12094-023-03369-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/05/2023] [Indexed: 02/28/2024]
Abstract
PURPOSE The optimal drug regimen and sequence are still unknown for patients with metastatic colorectal cancer (mCRC) who are candidates for third-line (3L) or subsequent treatment. The aim of this study is to know the opinion of experts on the most appropriate treatment options for mCRC in 3L and to clarify certain clinical decisions in Spain. METHODS Using a modified Delphi method, a group of experts discussed the treatment in 3L of patients with mCRC and developed a questionnaire with 21 items divided into 5 sections. RESULTS After 2 rounds, the 67 panelists consulted agreed on 17 items (81%). They considered that the main objective of 3L is to equally increase survival and improve patients' quality of life (QoL), but preferably the QoL. It was agreed that patients with mCRC in 3L prefer to receive active versus symptomatic treatment. Panelists considered trifluridine/tipiracil (FTD/TPI) to be the best oral treatment available to them in 3L. In patients with MSI-H or dMMR and BRAF V600E, the panelists mostly prefer targeted treatments. Panelists agreed the use of a therapeutic sequence that not only increases outcomes but also allows patients to be treated later. Finally, it was agreed that FTD/TPI has a mechanism of action that allows it to be used in patients refractory to previous treatment with 5-fluorouracil. CONCLUSION The experts agreed with most of the proposed items on 3L treatment of mCRC, prioritizing therapeutic options that increase survival and preserve QoL, while facilitating the possibility that patients can continue to be treated later.
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Affiliation(s)
- Pilar García-Alfonso
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria (IiSGM), Universidad Complutense de Madrid, C/ Dr. Esquerdo, 46, 28007, Madrid, Spain.
| | - Ruth Vera
- Department of Oncology, University Hospital of Navarra, Instituto de Investigación Sanitaria de Navarra (IdISNA), Pamplona, Navarra, Spain
| | - Enrique Aranda
- Department of Medical Oncology, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Córdoba, Spain
| | - Elena Élez
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Rivera
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
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2
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Wang C, Wang W, Wang M, Deng J, Sun C, Hu Y, Luo S. Different evasion strategies in multiple myeloma. Front Immunol 2024; 15:1346211. [PMID: 38464531 PMCID: PMC10920326 DOI: 10.3389/fimmu.2024.1346211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/09/2024] [Indexed: 03/12/2024] Open
Abstract
Multiple myeloma is the second most common malignant hematologic malignancy which evolved different strategies for immune escape from the host immune surveillance and drug resistance, including uncontrolled proliferation of malignant plasma cells in the bone marrow, genetic mutations, or deletion of tumor antigens to escape from special targets and so. Therefore, it is a big challenge to efficiently treat multiple myeloma patients. Despite recent applications of immunomodulatory drugs (IMiDS), protease inhibitors (PI), targeted monoclonal antibodies (mAb), and even hematopoietic stem cell transplantation (HSCT), it remains hardly curable. Summarizing the possible evasion strategies can help design specific drugs for multiple myeloma treatment. This review aims to provide an integrative overview of the intrinsic and extrinsic evasion mechanisms as well as recently discovered microbiota utilized by multiple myeloma for immune evasion and drug resistance, hopefully providing a theoretical basis for the rational design of specific immunotherapies or drug combinations to prevent the uncontrolled proliferation of MM, overcome drug resistance and improve patient survival.
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Affiliation(s)
| | | | | | | | | | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shanshan Luo
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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3
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Navarro Matilla B, Ortiz Romero PL, Pujol Vallverdú RM, Combalia Escudero A, Zapata Paz I, González Barca E, Muniesa Montserrat C, Morillo Andújar M, Pérez Ferriols A, Román Curto C, Fernández de Misa Cabrera R, Hospital Gil M, Marín Niebla A, Rios Rull PJ, de la Cruz Vicente F, Izu Belloso RM, Martín García-Sancho A, Parera Amer ME, Córdoba Mascuñano R, Ramón Quiles MD, Saus Carreres A, Del Campo García R, Machan S, Viguera Ester P, Blanco Garnelo J. Cost of Treating Cutaneous T-Cell Lymphoma in Spain: Analysis of MICADOS Study Data by Disease Stage. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:119-129. [PMID: 37689349 DOI: 10.1016/j.ad.2023.08.007] [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: 05/10/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The cost of treating cutaneous T-cell lymphoma (CTCL) in Spain is unknown. With the advent of new treatments, it is more important than ever to gain an accurate picture of the true costs involved. The MICADOS study had 2 primary objectives: 1)to evaluate the impact of CTCL on patient quality of life, and 2)to evaluate the costs associated with the disease. This article reports the results of the cost analysis. METHODS We estimated the cost of treating CTCL over a period of 1year from the perspective of the Spanish National Health System. Twenty-three dermatologists and hematologists from 15 public hospitals analyzed data for adult patients with mycosis fungoides (MF) or Sézary syndrome (SS). RESULTS A total of 141 patients (57.4% male) with a mean age of 63.6 years (95%CI: 61.4-65.7 years) were included. The mean direct annual cost of treating CTCL was €34,214 per patient. The corresponding costs by stage were €11,952.47 for stageI disease, €23,506.21 for stageII disease, €38,771.81 for stageIII disease, and €72,748.84 for stageIV disease. The total direct annual cost of treating MF/SS in public hospitals in Spain was estimated at €78,301,171; stageI disease accounted for 81% of all costs, stageII for 7%, and stagesIII andIV for 6% each. CONCLUSIONS The MICADOS study offers an accurate picture of the direct cost of treating CTCL in patients with MF/SS in Spain and shows that costs vary significantly according to disease stage. Patient-borne and indirect costs should be analyzed in future studies.
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Affiliation(s)
- B Navarro Matilla
- Departamento de Hematología, Hospital Universitario Puerta de Hierro, Madrid, España
| | - P L Ortiz Romero
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | | | - A Combalia Escudero
- Departamento de Dermatología, Hospital Universitario Clínic i Provincial, Barcelona, España
| | - I Zapata Paz
- Departamento de Radiación Oncológica, Hospital Universitario Puerta de Hierro, Madrid, España
| | - E González Barca
- Departamento de Hematología, Institut Catalá d'Oncología, Hospitalet de Llobregat, Barcelona, España
| | - C Muniesa Montserrat
- Departamento de Dermatología, Hospital Universitario de Bellvitge, Barcelona, España
| | - M Morillo Andújar
- Departamento de Dermatología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - A Pérez Ferriols
- Departamento de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - C Román Curto
- Departamento de Dermatología, Hospital General Universitario de Salamanca, Salamanca, España
| | - R Fernández de Misa Cabrera
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - M Hospital Gil
- Departamento de Dermatología, Hospital Universitario Puerta de Hierro, Madrid, España
| | - A Marín Niebla
- Departamento de Hematología, Hospital Universitario Vall d'Hebron/VHIO, Barcelona, España
| | - P J Rios Rull
- Departamento de Hematología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - F de la Cruz Vicente
- Departamento de Hematología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - R M Izu Belloso
- Departamento de Dermatología, Hospital de Basurto, Bilbao, España
| | - A Martín García-Sancho
- Departamento de Hematología, Hospital General Universitario de Salamanca, Salamanca, España
| | - M E Parera Amer
- Departamento de Dermatología, Hospital Son Llàtzer, Palma de Mallorca, España
| | - R Córdoba Mascuñano
- Departamento de Hematología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - M D Ramón Quiles
- Departamento de Dermatología, Hospital Clínico Universitario, Valencia, España
| | - A Saus Carreres
- Departamento de Hematología, Hospital Clínico Universitario, Valencia, España
| | - R Del Campo García
- Departamento de Hematología, Hospital Son Llàtzer, Palma de Mallorca, España
| | - S Machan
- Departamento de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - P Viguera Ester
- Departamento Médico, Kyowa Kirin Farmacéutica, S.L., Madrid, España
| | - J Blanco Garnelo
- Departamento Médico, Kyowa Kirin Farmacéutica, S.L., Madrid, España.
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4
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Navarro Matilla B, Ortiz Romero PL, Pujol Vallverdú RM, Combalia Escudero A, Zapata Paz I, González Barca E, Muniesa Montserrat C, Morillo Andújar M, Pérez Ferriols A, Román Curto C, Fernández de Misa Cabrera R, Hospital Gil M, Marín Niebla A, Rios Rull PJ, de la Cruz Vicente F, Izu Belloso RM, Martín García-Sancho A, Parera Amer ME, Córdoba Mascuñano R, Ramón Quiles MD, Saus Carreres A, Del Campo García R, Machan S, Viguera Ester P, Blanco Garnelo J. [Translated article] Cost of Treating Cutaneous T-Cell Lymphoma in Spain: Analysis of MICADOS Study Data by Disease Stage. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T119-T129. [PMID: 38048944 DOI: 10.1016/j.ad.2023.11.017] [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: 05/10/2023] [Accepted: 08/08/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The cost of treating cutaneous T-cell lymphoma (CTCL) in Spain is unknown. With the advent of new treatments, it is more important than ever to gain an accurate picture of the true costs involved. The MICADOS study had 2 primary objectives: 1)to evaluate the impact of CTCL on patient quality of life, and 2)to evaluate the costs associated with the disease. This article reports the results of the cost analysis. METHODS We estimated the cost of treating CTCL over a period of 1year from the perspective of the Spanish National Health System. Twenty-three dermatologists and hematologists from 15 public hospitals analyzed data for adult patients with mycosis fungoides (MF) or Sézary syndrome (SS). RESULTS A total of 141 patients (57.4% male) with a mean age of 63.6 years (95%CI: 61.4-65.7 years) were included. The mean direct annual cost of treating CTCL was €34,214 per patient. The corresponding costs by stage were €11,952.47 for stageI disease, €23,506.21 for stageII disease, €38,771.81 for stageIII disease, and €72,748.84 for stageIV disease. The total direct annual cost of treating MF/SS in public hospitals in Spain was estimated at €78,301,171; stageI disease accounted for 81% of all costs, stageII for 7%, and stagesIII andIV for 6% each. CONCLUSIONS The MICADOS study offers an accurate picture of the direct cost of treating CTCL in patients with MF/SS in Spain and shows that costs vary significantly according to disease stage. Patient-borne and indirect costs should be analyzed in future studies.
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Affiliation(s)
- B Navarro Matilla
- Departamento de Hematología, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - P L Ortiz Romero
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - A Combalia Escudero
- Departamento de Dermatología, Hospital Universitario Clínic i Provincial, Barcelona, Spain
| | - I Zapata Paz
- Departamento de Radiación Oncológica, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - E González Barca
- Departamento de Hematología, Institut Catalá d'Oncología, Hospitalet de Llobregat, Barcelona, Spain
| | - C Muniesa Montserrat
- Departamento de Dermatología, Hospital Universitario de Bellvitge, Barcelona, Spain
| | - M Morillo Andújar
- Departamento de Dermatología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - A Pérez Ferriols
- Departamento de Dermatología, Hospital General Universitario de Valencia, Valencia, Spain
| | - C Román Curto
- Departamento de Dermatología, Hospital General Universitario de Salamanca, Salamanca, Spain
| | - R Fernández de Misa Cabrera
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - M Hospital Gil
- Departamento de Dermatología, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - A Marín Niebla
- Departamento de Hematología, Hospital Universitario Vall d'Hebron/VHIO, Barcelona, Spain
| | - P J Rios Rull
- Departamento de Hematología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - F de la Cruz Vicente
- Departamento de Hematología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - R M Izu Belloso
- Departamento de Dermatología, Hospital de Basurto, Bilbao, Spain
| | - A Martín García-Sancho
- Departamento de Hematología, Hospital General Universitario de Salamanca, Salamanca, Spain
| | - M E Parera Amer
- Departamento de Dermatología, Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - R Córdoba Mascuñano
- Departamento de Hematología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M D Ramón Quiles
- Departamento de Dermatología, Hospital Clínico Universitario, Valencia, Spain
| | - A Saus Carreres
- Departamento de Hematología, Hospital Clínico Universitario, Valencia, Spain
| | - R Del Campo García
- Departamento de Hematología, Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - S Machan
- Departamento de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - P Viguera Ester
- Departamento Médico, Kyowa Kirin Farmacéutica, S.L., Madrid, Spain
| | - J Blanco Garnelo
- Departamento Médico, Kyowa Kirin Farmacéutica, S.L., Madrid, Spain.
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5
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Navarro-Sabate A, Font R, Martínez-Soler F, Solà J, Tortosa A, Ribes J, Benito-Aracil L, Espinas JA, Borras JM. The Impact of the COVID-19 Pandemic on Adherence to Endocrine Therapy for Breast Cancer in Catalonia (Spain). Cancers (Basel) 2024; 16:426. [PMID: 38275867 PMCID: PMC10814820 DOI: 10.3390/cancers16020426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Purpose. To assess the impact of the COVID-19 pandemic on adherence to oral endocrine therapy in patients diagnosed with breast cancer in the public healthcare system in Catalonia (Spain). Methods. Retrospective cohort study in patients starting endocrine therapy from 2017 to 2021. Adherence was measured during the first year of treatment, and the impact of the pandemic was calculated according to the calendar year and whether the first year of treatment included the peak period of the pandemic in our setting (March-September 2020). Analyses were performed using a chi-square test and multivariable logistic regression, with results stratified by year, age group, and drug type. Results. Mean overall adherence during the first year of treatment was 89.6% from 2017 to 2021. In contrast, the patients who started treatment in 2019 and 2020 and whose treatment included the peak pandemic period presented an adherence of 87.0% and 86.5%, respectively. Young age and tamoxifen or combination therapy were predictors of low adherence. An increase in neoadjuvant therapy was also observed in 2020. Conclusions. The COVID-19 pandemic had only a modest impact on adherence to endocrine therapy (≈3%), despite the enormous disruptions for patients, the healthcare system in general, and cancer care in particular that were occurring in that period.
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Affiliation(s)
- Aurea Navarro-Sabate
- Fundamental Care and Clinical Nursing Department, Nursing Faculty, University of Barcelona, 08007 Barcelona, Spain; (A.N.-S.); (F.M.-S.); (A.T.); (L.B.-A.)
| | - Rebeca Font
- Catalan Cancer Plan, Department of Health, 08908 Barcelona, Spain; (R.F.); (J.R.); (J.A.E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
| | - Fina Martínez-Soler
- Fundamental Care and Clinical Nursing Department, Nursing Faculty, University of Barcelona, 08007 Barcelona, Spain; (A.N.-S.); (F.M.-S.); (A.T.); (L.B.-A.)
| | - Judit Solà
- Catalan Cancer Plan, Department of Health, 08908 Barcelona, Spain; (R.F.); (J.R.); (J.A.E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
| | - Avelina Tortosa
- Fundamental Care and Clinical Nursing Department, Nursing Faculty, University of Barcelona, 08007 Barcelona, Spain; (A.N.-S.); (F.M.-S.); (A.T.); (L.B.-A.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
| | - Josepa Ribes
- Catalan Cancer Plan, Department of Health, 08908 Barcelona, Spain; (R.F.); (J.R.); (J.A.E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
- Clinical Sciences Department, University of Barcelona, 08907 Barcelona, Spain
| | - Llúcia Benito-Aracil
- Fundamental Care and Clinical Nursing Department, Nursing Faculty, University of Barcelona, 08007 Barcelona, Spain; (A.N.-S.); (F.M.-S.); (A.T.); (L.B.-A.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
| | - Josep Alfons Espinas
- Catalan Cancer Plan, Department of Health, 08908 Barcelona, Spain; (R.F.); (J.R.); (J.A.E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
- Clinical Sciences Department, University of Barcelona, 08907 Barcelona, Spain
| | - Josep Maria Borras
- Catalan Cancer Plan, Department of Health, 08908 Barcelona, Spain; (R.F.); (J.R.); (J.A.E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet, 08907 Barcelona, Spain
- Clinical Sciences Department, University of Barcelona, 08907 Barcelona, Spain
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6
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Ocio EM, Montes-Gaisán C, Bustamante G, Garzón S, González E, Pérez-Persona E, González-Calle V, Sirvent M, Arguiñano JM, González Y, Ríos R, de Miguel D, Grande M, Fernández-Nistal A, Naves A, Rosiñol L. Real-World Health Care Services Utilization Associated With the Management of Patients With Relapsed and Refractory Multiple Myeloma in Spain: The CharisMMa Study. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2023; 23:e341-e347. [PMID: 37517875 DOI: 10.1016/j.clml.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/05/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Most patients with multiple myeloma (MM) relapse or become refractory, resulting in high health care costs. However, real-world data regarding the utilization of health care services among the relapsed/refractory MM (RRMM) population are scarce. METHODS Observational, cross-sectional, multicenter study of the utilization of health care services by RRMM patients who had relapsed within the previous 6 months in Spain in a real-world setting. Data were collected from the clinical records and during a single structured interview and included sociodemographic and clinical characteristics at last relapse, the treatment and health care services nature, and were presented using descriptive statistics. RESULTS The 276 patients enrolled (53.3% males), with a mean [SD] age of 67.4 [10.5] years, had experienced their most recent relapse a median (IQR) of 1.61 (0.74, 3.14) months before entering the study. Patients lived a median (IQR) of 9.0 (3.0, 30.0) km away from the hospital and visited the hospital a median (IQR) of 3.0 (2.0, 5.0) times/month to receive treatment for their most recent relapse. They spent a median (IQR) of 15.84 (5.0, 42.0) euros/month on transportation. Since their most recent relapse, most patients had been admitted to a hospital unit (n = 155, 56.2%), had required ≥1 diagnostic tests (n = 227, 82.2%), and had consulted the hematologist (n = 270, 97.8%) a mean (SD) of 5.5 (5.4) times. In half of the visits, patients were accompanied by an actively working caregiver (n = 112, 54.4%). CONCLUSIONS RRMM treatments are associated with a high utilization of health care services and pose a significant burden for patients and caregivers. TRIAL REGISTRATION NUMBER NCT03188536.
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Affiliation(s)
- Enrique M Ocio
- Hospital Universitario Marqués de Valdecilla (IDIVAL), Universidad de Cantabria, Santander, Spain
| | - Carmen Montes-Gaisán
- Hospital Universitario Marqués de Valdecilla (IDIVAL), Universidad de Cantabria, Santander, Spain
| | - Gabriela Bustamante
- Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Ernesto Pérez-Persona
- Department of Hematology, Bioaraba, Onco-hematology research group, Vitoria-Gasteiz, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain
| | - Verónica González-Calle
- Hospital Universitario de Salamanca (HUS/IBSAL), CIBERONC, Instituto de Investigación Biomédica de Salamanca-IBMCC (USAL-CSIC), Salamanca, Spain
| | | | | | | | - Rafael Ríos
- Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | | | - Marta Grande
- Takeda Farmacéutica España, Madrid, Spain; Universidad de Alcalá, Madrid, Spain
| | | | | | - Laura Rosiñol
- Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
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Redondo-Sánchez D, Fernández-Navarro P, Rodríguez-Barranco M, Nuñez O, Petrova D, García-Torrecillas JM, Jiménez-Moleón JJ, Sánchez MJ. Socio-economic inequalities in lung cancer mortality in Spain: a nation-wide study using area-based deprivation. Int J Equity Health 2023; 22:145. [PMID: 37533035 PMCID: PMC10399030 DOI: 10.1186/s12939-023-01970-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/19/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Lung cancer is the main cause of cancer mortality worldwide and in Spain. Several previous studies have documented socio-economic inequalities in lung cancer mortality but these have focused on specific provinces or cities. The goal of this study was to describe lung cancer mortality in Spain by sex as a function of socio-economic deprivation. METHODS We analysed all registered deaths from lung cancer during the period 2011-2017 in Spain. Mortality data was obtained from the National Institute of Statistics, and socio-economic level was measured with the small-area deprivation index developed by the Spanish Society of Epidemiology, with the census tract of residence at the time of death as the unit of analysis. We computed crude and age-standardized rates per 100,000 inhabitants by sex, deprivation quintile, and type of municipality (rural, semi-rural, urban) considering the 2013 European standard population (ASR-E). We further calculated ASR-E ratios between the most deprived (Q5) and the least deprived (Q1) areas and mapped census tract smoothed standardized lung cancer mortality ratios by sex. RESULTS We observed 148,425 lung cancer deaths (80.7% in men), with 73.5 deaths per 100,000 men and 17.1 deaths per 100,000 women. Deaths from lung cancer in men were five times more frequent than in women (ASR-E ratio = 5.3). Women residing in the least deprived areas had higher mortality from lung cancer (ASR-E = 22.2), compared to women residing in the most deprived areas (ASR-E = 13.2), with a clear gradient among the quintiles of deprivation. For men, this pattern was reversed, with the highest mortality occurring in areas of lower socio-economic level (ASR-E = 99.0 in Q5 vs. ASR-E = 86.6 in Q1). These socio-economic inequalities remained fairly stable over time and across urban and rural areas. CONCLUSIONS Socio-economic status is strongly related to lung cancer mortality, showing opposite patterns in men and women, such that mortality is highest in women residing in the least deprived areas and men residing in the most deprived areas. Systematic surveillance of lung cancer mortality by socio-economic status may facilitate the assessment of public health interventions aimed at mitigating cancer inequalities in Spain.
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Grants
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- Not applicable Acciones de Movilidad CIBERESP, 2022
- JC2019-039691-I Juan de la Cierva Fellowship from the Ministry of Science and the National Research Agency of Spain
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Affiliation(s)
- Daniel Redondo-Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain.
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain.
| | - Pablo Fernández-Navarro
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, 28029, Spain
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
| | - Olivier Nuñez
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, 28029, Spain
| | - Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
| | - Juan Manuel García-Torrecillas
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Emergency and Research Unit, Torrecárdenas University Hospital, Almería, 04009, Spain
| | - Jose Juan Jiménez-Moleón
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, 18071, Spain
| | - María-José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
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8
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Vaamonde-Martín RJ, Ballesta-Ruiz M, Sánchez-Gil A, Fernández JÁ, Martínez-Barba E, Martínez-García J, Gatta G, Chirlaque-López MD. Incidence Trends and Main Features of Gastro-Intestinal Stromal Tumours in a Mediterranean Region: A Population-Based Study. Cancers (Basel) 2023; 15:cancers15112994. [PMID: 37296956 DOI: 10.3390/cancers15112994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Gastro-Intestinal Stromal Tumours (GISTs) are a kind of neoplasm whose diagnosis in common clinical practice just started in the current century, implying difficulties for proper registration. Staff from the Cancer Registry of Murcia, in southeastern Spain, were commissioned by the EU Joint Action on Rare Cancers into a pilot study addressing GIST registration that also yielded a population-based depiction of GISTs in the region, including survival figures. We examined reports from 2001 to 2015 from hospitals as well as cases already present in the registry. The variables collected were sex, date of diagnosis, age, vital status, primary location, presence of metastases, and risk level according to Joensuu's Classification. In total, 171 cases were found, 54.4% occurred in males, and the mean age value was 65.0 years. The most affected organ was the stomach, with 52.6% of cases. Risk level was determined as "High" for 45.0%, with an increment of lower levels in recent years. Incidence for the year 2015 doubled that of 2001. Overall, the 5-year net survival estimation was 77.0%. The rising incidence magnitude is consistent with trends in other European countries. Survival evolution lacked statistical significance. A more interventional approach in clinical management could explain the increase in the proportion of "Low Risk GISTs" and the first occurrence of "Very Low Risk" in recent years.
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Affiliation(s)
- Ricardo J Vaamonde-Martín
- Service of Epidemiology, Region of Murcia Health Council, Ronda de Levante 11, 30008 Murcia, Spain
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 Murcia, Spain
| | - Mónica Ballesta-Ruiz
- Service of Epidemiology, Region of Murcia Health Council, Ronda de Levante 11, 30008 Murcia, Spain
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 Murcia, Spain
- School of Medicine, University of Murcia, 30100 Murcia, Spain
| | - Antonia Sánchez-Gil
- Service of Epidemiology, Region of Murcia Health Council, Ronda de Levante 11, 30008 Murcia, Spain
- SMS (Region of Murcia Health Service) Calle Central, 7, 30100 Murcia, Spain
| | - Juan Ángel Fernández
- School of Medicine, University of Murcia, 30100 Murcia, Spain
- University Hospital "Virgen de la Arrixaca", 30120 Murcia, Spain
| | - Enrique Martínez-Barba
- School of Medicine, University of Murcia, 30100 Murcia, Spain
- University Hospital "Virgen de la Arrixaca", 30120 Murcia, Spain
| | | | - Gemma Gatta
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20131 Milan, Italy
| | - María D Chirlaque-López
- Service of Epidemiology, Region of Murcia Health Council, Ronda de Levante 11, 30008 Murcia, Spain
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 Murcia, Spain
- School of Medicine, University of Murcia, 30100 Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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9
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Etxeberria J, Goicoa T, Ugarte MD. Using mortality to predict incidence for rare and lethal cancers in very small areas. Biom J 2023; 65:e2200017. [PMID: 36180401 DOI: 10.1002/bimj.202200017] [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: 01/19/2022] [Revised: 06/17/2022] [Accepted: 08/14/2022] [Indexed: 11/11/2022]
Abstract
Incidence and mortality figures are needed to get a comprehensive overview of cancer burden. In many countries, cancer mortality figures are routinely recorded by statistical offices, whereas incidence depends on regional cancer registries. However, due to the complexity of updating cancer registries, incidence numbers become available 3 or 4 years later than mortality figures. It is, therefore, necessary to develop reliable procedures to predict cancer incidence at least until the period when mortality data are available. Most of the methods proposed in the literature are designed to predict total cancer (except nonmelanoma skin cancer) or major cancer sites. However, less frequent lethal cancers, such as brain cancer, are generally excluded from predictions because the scarce number of cases makes it difficult to use univariate models. Our proposal comes to fill this gap and consists of modeling jointly incidence and mortality data using spatio-temporal models with spatial and age shared components. This approach allows for predicting lethal cancers improving the performance of individual models when data are scarce by taking advantage of the high correlation between incidence and mortality. A fully Bayesian approach based on integrated nested Laplace approximations is considered for model fitting and inference. A validation process is also conducted to assess the performance of alternative models. We use the new proposals to predict brain cancer incidence rates by gender and age groups in the health units of Navarre and Basque Country (Spain) during the period 2005-2008.
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Affiliation(s)
- Jaione Etxeberria
- Department of Statistics, Computer Science and Mathematics, Public University of Navarre (UPNA), Campus Arrosadia, Pamplona, Navarre, Spain
- Institute for Advanced Materials and Mathematics (INAMAT2), Public University of Navarre (UPNA), Campus Arrosadia, Pamplona, Navarre, Spain
| | - Tomás Goicoa
- Department of Statistics, Computer Science and Mathematics, Public University of Navarre (UPNA), Campus Arrosadia, Pamplona, Navarre, Spain
- Institute for Advanced Materials and Mathematics (INAMAT2), Public University of Navarre (UPNA), Campus Arrosadia, Pamplona, Navarre, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
| | - Maria D Ugarte
- Department of Statistics, Computer Science and Mathematics, Public University of Navarre (UPNA), Campus Arrosadia, Pamplona, Navarre, Spain
- Institute for Advanced Materials and Mathematics (INAMAT2), Public University of Navarre (UPNA), Campus Arrosadia, Pamplona, Navarre, Spain
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10
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Donat-Vargas C, Kogevinas M, Castaño-Vinyals G, Pérez-Gómez B, Llorca J, Vanaclocha-Espí M, Fernandez-Tardon G, Costas L, Aragonés N, Gómez-Acebo I, Moreno V, Pollan M, Villanueva CM. Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Prostate Cancer: A Multicase-Control Study in Spain (MCC-Spain). ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:37004. [PMID: 36883836 PMCID: PMC9994181 DOI: 10.1289/ehp11391] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 01/20/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Nitrate and trihalomethanes (THMs) in drinking water are widespread and are potential human carcinogens. OBJECTIVE We evaluated the association between drinking-water exposure to nitrate and THMs and prostate cancer. METHODS During the period 2008-2013, 697 hospital-based incident prostate cancer cases (97 aggressive tumors) and 927 population-based controls were recruited in Spain, providing information on residential histories and type of water consumed. Average nitrate and THMs levels in drinking water were linked with lifetime water consumption to calculate waterborne ingestion. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using mixed models with recruitment area as random effect. Effect modification by tumor grade (Gleason score), age, education, lifestyle, and dietary factors was explored. RESULTS Mean (±standard deviation) adult lifetime waterborne ingested nitrate (milligrams per day), brominated (Br)-THMs (micrograms per day), and chloroform (micrograms per day) were 11.5 (±9.0), 20.7 (±32.4), and 15.1 (±14.7) in controls. Waterborne ingested nitrate >13.8 vs. <5.5mg/d was associated with an OR of 1.74 (95% CI: 1.19, 2.54) overall, and 2.78 (95% CI: 1.23, 6.27) for tumors with Gleason scores ≥8. Associations were higher in the youngest and those with lower intakes of fiber, fruit/vegetables, and vitamin C. Waterborne ingested THMs were not associated with prostate cancer. Residential tap water levels of Br-THMs and chloroform showed, respectively, inverse and positive associations with prostate cancer. CONCLUSIONS Findings suggest long-term waterborne ingested nitrate could be a risk factor of prostate cancer, particularly for aggressive tumors. High intakes of fiber, fruit/vegetables and vitamin C may lower this risk. Association with residential levels but not ingested chloroform/Br-THM may suggest inhalation and dermal routes could be relevant for prostate cancer. https://doi.org/10.1289/EHP11391.
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Affiliation(s)
- Carolina Donat-Vargas
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manolis Kogevinas
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Gemma Castaño-Vinyals
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Beatriz Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Faculty of Medicine, University of Cantabria, Spain
| | - Mercedes Vanaclocha-Espí
- Cancer and Public Health Area, Foundation for the Promotion of Health and Biomedical Research-Public Health Research (FISABIO), Valencia, Spain
| | - Guillermo Fernandez-Tardon
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Health Research Institute of Asturias (ISPA), Oviedo, Spain
| | - Laura Costas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Inés Gómez-Acebo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Faculty of Medicine, University of Cantabria, Spain
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | - Victor Moreno
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Unit of Biomarkers and Susceptibility, Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), Hospitalet de Llobregat, Spain
- Colorectal Cancer Group, IDIBELL, Hospitalet de Llobregat, Spain
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Marina Pollan
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Cristina M. Villanueva
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
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11
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Luizaga CTDM, Buchalla CM. [Estimation of cancer incidence in the state of São Paulo, Brazil, based on real data]. CAD SAUDE PUBLICA 2023; 39:e00134222. [PMID: 36820739 DOI: 10.1590/0102-311xpt134222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/06/2023] [Indexed: 02/22/2023] Open
Abstract
This study aims to evaluate the feasibility of applying a method of estimating the incidence of cancer to regions of the state of São Paulo, Brazil, from real data (not estimated) and retrospectively comparing the results obtained with the official estimates. A method based on mortality and on the incidence to mortality (I/M) ration was used according to sex, age, and tumor location. In the I/M numerator, new cases of cancer were used from the population records of Jaú and São Paulo from 2006-2010; in the denominator, deaths from 2006-2010 in the respective areas, extracted from the national mortality system. The estimates resulted from the multiplication of I/M by the number of cancer deaths in 2010 for each region. Population data from the 2010 Demographic Census were used to estimate incidence rates. For the adjustment by age, the world standard population was used. We calculated the relative differences between the gross incidence rates estimated in this study and the official ones. Age-adjusted cancer incidence rates were 260.9/100,000 for men and 216.6/100,000 for women. Prostate cancer was the most common in males, whereas breast cancer was most common in females. Differences between the rates of this study and the official rates were 3.3% and 1.5% for each sex. The estimated incidence was compatible with the officially presented state profile, indicating that the application of real data did not alter the morbidity profile, while it did indicate different risk magnitudes. Despite the over-representativeness of the cancer registry with greater population coverage, the selected method proved feasible to point out different patterns within the state.
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12
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Vera R, Juan-Vidal O, Safont-Aguilera MJ, de la Peña FA, Del Alba AG. Sex differences in the diagnosis, treatment and prognosis of cancer: the rationale for an individualised approach. Clin Transl Oncol 2023:10.1007/s12094-023-03112-w. [PMID: 36802013 DOI: 10.1007/s12094-023-03112-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/02/2023] [Indexed: 02/21/2023]
Abstract
BACKGROUND Precision medicine in oncology aims to identify the most beneficial interventions based on a patient's individual features and disease. However, disparities exist when providing cancer care to patients based on an individual's sex. OBJECTIVE To discuss how sex differences impact the epidemiology, pathophysiology, clinical manifestations, disease progression, and response to treatment, with a focus on data from Spain. RESULTS Genetic and environmental factors (social or economic inequalities, power imbalances, and discrimination) that contribute to these differences adversely affect cancer patient health outcomes. Increased health professional awareness of sex differences is essential to the success of translational research and clinical oncological care. CONCLUSIONS The Sociedad Española de Oncología Médica created a Task Force group to raise oncologists' awareness and to implement measures to address sex differences in cancer patient management in Spain. This is a necessary and fundamental step towards optimizing precision medicine that will benefit all individuals equally and equitably.
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Affiliation(s)
- Ruth Vera
- Department of Medical Oncology, University Hospital of Navarra, Pamplona. IdiSNA, Navarra's Health Research Institute, Irunlarrea 3, 31190, Pamplona, Spain.
| | - Oscar Juan-Vidal
- Department of Medical Oncology, University Hospital La Fe, Valencia, Spain
| | - María José Safont-Aguilera
- Department of Medical Oncology, University General Hospital of Valencia, Valencia University, Valencia. CIBERONC, Valencia, Spain
| | - Francisco Ayala de la Peña
- Medical Oncology, Department of Haematology and Oncology, University General Hospital Morales Meseguer, Murcia, Spain
| | - Aránzazu González Del Alba
- Genitourinary Tumour Unit, Department of Medical Oncology, University Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
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13
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PET/TC con FDG y nuevos radiofármacos en pacientes con mieloma múltiple. Rev Esp Med Nucl Imagen Mol 2023. [DOI: 10.1016/j.remn.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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14
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Chang-Azancot L, Abizanda P, Gijón M, Kenig N, Campello M, Juez J, Talaya A, Gómez-Bajo G, Montón J, Sánchez-Bayona R. Age and Breast Reconstruction. Aesthetic Plast Surg 2023; 47:63-72. [PMID: 35927500 DOI: 10.1007/s00266-022-03024-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/10/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Breast reconstruction is frequently offered to cancer patients who undergo mastectomy. Older women tend to have lower rates of reconstruction mostly due to an age-based discretion. We aimed to assess the safety of this surgery in this population. METHODS We conducted a single-center retrospective analysis of patients who underwent breast reconstruction following mastectomy between 2015 and 2020 at "Complejo Hospitalario Universitario de Albacete." Patients were classified according to age when the reconstruction process began (group A: < 65 years-group B: > 65 years). Differences in demographics and clinical data were analyzed using Student's t test and Chi-square test. Multivariable logistic regression models were used to estimate odds ratio (OR) and confidence intervals (CIs) for surgical complications according to age group. Propensity-score matching was used as a sensitivity analysis to test consistency among results. RESULTS We included 304 women (266: group A-38: group B). Complete reconstruction was achieved in 48.1% of patients in group A vs 10.5% in group B (P < 0.001). After adjusting for potential confounders, age was not associated with an increased risk of surgical complications, neither overall (OR 0.88, 95%CI 0.40-1.95), early (OR 1.35, 95%CI 0.58-3.13) nor late (OR 1.05, 95%CI 0.40-2.81). Radiotherapy and smoking history were significant predictors for complications in every setting. CONCLUSIONS In our cohort, age at breast reconstruction is not associated with a higher risk of surgical complications, in contrast to radiotherapy and smoking history. Therefore, age should not be a limiting factor when considering breast reconstruction. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Luis Chang-Azancot
- Plastic Surgery Department, Complejo Hospitalario Universitario de Albacete, 02006, Albacete, Spain.
| | - Pedro Abizanda
- Geriatrics Department, Complejo Hospitalario Universitario of Albacete, Albacete, Spain.,CIBERFES, Instituto de Salud Carlos III, Madrid, Spain
| | - María Gijón
- Plastic Surgery Department, Complejo Hospitalario Universitario de Albacete, 02006, Albacete, Spain
| | - Nitzan Kenig
- Plastic Surgery Department, Complejo Hospitalario Universitario de Albacete, 02006, Albacete, Spain
| | - Manuel Campello
- Plastic Surgery Department, Complejo Hospitalario Universitario de Albacete, 02006, Albacete, Spain
| | - Jessica Juez
- Plastic Surgery Department, Complejo Hospitalario Universitario de Albacete, 02006, Albacete, Spain
| | - Antonio Talaya
- Plastic Surgery Department, Complejo Hospitalario Universitario de Albacete, 02006, Albacete, Spain
| | - Gregorio Gómez-Bajo
- Plastic Surgery Department, Complejo Hospitalario Universitario de Albacete, 02006, Albacete, Spain
| | - Javier Montón
- Plastic Surgery Department, Complejo Hospitalario Universitario de Albacete, 02006, Albacete, Spain.,Anatomy and Embryology Unit, Faculty of Medicine, University of Castilla-La Mancha (UCLM), Albacete, Spain
| | - Rodrigo Sánchez-Bayona
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, 28041, Madrid, Spain
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15
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Nova-Camacho LM, Gomez-Dorronsoro M, Guarch R, Cordoba A, Cevallos MI, Panizo-Santos A. Cardiac Metastasis From Solid Cancers: A 35-Year Single-Center Autopsy Study. Arch Pathol Lab Med 2023; 147:177-184. [PMID: 35639589 DOI: 10.5858/arpa.2021-0418-oa] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 02/05/2023]
Abstract
CONTEXT.— Cardiac metastases are more prevalent than primary cardiac tumors, and although rare, the incidence is anticipated to increase with the extended survival of oncology patients. OBJECTIVE.— To estimate the current incidence of cardiac metastasis from solid tumors in adult autopsies. DESIGN.— Adult autopsy cases from 1984 through 2019 from patients diagnosed with any type of solid cancer were retrieved. The medical charts and pathologic autopsy data were reviewed in detail. RESULTS.— A total of 1294 adult autopsies performed on patients diagnosed with any type of cancer within the past 35 years were reviewed. We found 124 secondary cardiac tumors. Eighty-five were due to cardiac involvement by solid tumors. Of these, 61 were true cardiac metastases of solid cancers. We focused on these 61 cases. The age range was 32 to 85 years. Forty-four patients were men and 17 were women. The lung was the most common primary site, with 21 cases (34.43%). The most frequent histologic type was carcinoma, with 54 cases (88.52%). The predominant layer of the heart involved was the pericardium, with 35 cases (57.38%). Twenty-one cases (34.43%) had pericardial effusion, with 4 being hemorrhagic. All cases had multiple extracardiac metastases, with 56 cases (91.8%) having distant metastases in 4 or more different organs. CONCLUSIONS.— Cardiac metastasis is a rare occurrence, with an incidence of 4.71% (61 of 1294 cases) in our series. Lung cancer accounted for most of the cardiac metastases seen, and carcinomas were the most frequent histologic type. The pericardium was the most frequent location. Cardiac metastases occurred most frequently in cases of massive metastatic dissemination.
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Affiliation(s)
- Luiz M Nova-Camacho
- From the Department of Pathology, Hospital Universitario de Navarra, Pamplona, Spain
| | | | - Rosa Guarch
- From the Department of Pathology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Alicia Cordoba
- From the Department of Pathology, Hospital Universitario de Navarra, Pamplona, Spain
| | - M Isabel Cevallos
- From the Department of Pathology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Angel Panizo-Santos
- From the Department of Pathology, Hospital Universitario de Navarra, Pamplona, Spain
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16
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Aguilera-Buenosvinos I, Martínez-González MÁ, Zazpe I, Romanos-Nanclares A, Sánchez-Bayona R, Toledo E. Associations between overall, healthful, and unhealthful low-fat dietary patterns and breast cancer risk in a Mediterranean cohort: The SUN project. Nutrition 2023; 109:111967. [PMID: 36738657 DOI: 10.1016/j.nut.2022.111967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/25/2022] [Accepted: 12/31/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Dietary patterns may have a greater influence on human health than individual foods or nutrients, and they are also of substantial interest in the field of breast cancer prevention. Beyond the adequate balance of macronutrients, evidence indicates that the quality of macronutrient sources may play an important role in health outcomes. We sought to examine the relationship between healthful and unhealthful low-fat dietary patterns in relation to breast cancer. METHODS We used observational data from a Mediterranean cohort study (the Seguimiento Universidad de Navarra project). We prospectively followed 10 930 middle-aged women initially free of breast cancer during a median follow-up of 12.1 y. We calculated an overall, an unhealthful, and a healthful low-fat diet score, based on a previously validated 136-item food frequency questionnaire and grouped participants into tertiles. Incident breast cancer-overall and stratified by menopausal status-was the primary outcome. It was self-reported by participants and confirmed based on medical reports or consultation of the National Death Index. We used multivariable Cox regression models adjusted for potential confounders. RESULTS During 123 297 person-years of follow-up, 150 cases of incident breast cancer were confirmed. No significant associations were observed for overall or premenopausal breast cancer. For postmenopausal women, we observed a significant association for moderate adherence to the unhealthful low-fat dietary score and postmenopausal breast cancer (comparing tertile 2 to tertile 1; hazard ratio = 2.18; 95% confidence interval, 1.15-4.13). CONCLUSIONS In conclusion, no clear associations were observed, although more research is needed to address the association between an unhealthful dietary pattern and postmenopausal breast cancer risk.
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Affiliation(s)
- Inmaculada Aguilera-Buenosvinos
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research, IdiSNA, Pamplona, Spain
| | - Miguel Ángel Martínez-González
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research, IdiSNA, Pamplona, Spain; Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain; Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA USA
| | - Itziar Zazpe
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Department of Nutrition and Food Sciences and Physiology, University of Navarra, Irunlarrea, Spain
| | - Andrea Romanos-Nanclares
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Estefanía Toledo
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research, IdiSNA, Pamplona, Spain; Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain.
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17
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[Prostate cancer screening with Prostate-Specific Antigen (PSA) to men over 70 years old in an urban health zone, 2018-2020: A cross-sectional study]. Semergen 2023; 49:101876. [PMID: 36462252 DOI: 10.1016/j.semerg.2022.101876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/28/2022] [Accepted: 10/15/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES To describe the epidemiology and estimate the cost of Prostate-Specific Antigen (PSA) screening tests to men ≥ 70 years old in an urban health zone. METHODS A cross-sectional study was performed. We obtained every PSA test made in the health zone from 2018 to 2020, and classified them retrospectively as screening (PSAc) or not according to pre-established criteria, reviewing electronic health records. Testing rates were calculated by centres and clinical specialities. The standard population was provided by the city register of inhabitants (VM70). Cost estimation was made using our health system's price list. RESULTS Two thousand and thirty six PSA, of 888 men ≥ 70 years old were obtained, and 350 met screening classification criteria. Six adenocarcinomas were diagnosed from those tests. We estimated 76.07 PSAc/1000 VM70-year from any centre, 1.45 tests for each screened individual, and 15.71% prevalence. The standard population was 1534 men (mean 2018-2020, SD 45.37). Patients who were screened (median age 75, SD 4.04) were younger than those not screened. We estimated a total screening test cost of 9,751 €. CONCLUSIONS The epidemiology and cost of PSA screening tests to men ≥ 70 years old are reported, both in primary health care and in the hospital. PSA screening tests are common practice amongst professionals attending elderly men in our health zone, mostly in primary care. The screening testing rate of men without prostate cancer is similar to that reported in the literature.
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Cabrera-Rivera LT, Sweetser B, Fuster-Soler JL, Ramis R, López-Hernández FA, Pérez-Martínez A, Ortega-García JA. Looking Towards 2030: Strengthening the Environmental Health in Childhood-Adolescent Cancer Survivor Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:443. [PMID: 36612765 PMCID: PMC9819016 DOI: 10.3390/ijerph20010443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Childhood and adolescent cancer survivors (CACS) are a high-risk population for non-communicable diseases and secondary carcinogenesis. The Environmental and Community Health Program for Longitudinal Follow-up of CACS in the region of Murcia, Spain, is an ongoing pioneering program that constitutes a model for social innovation. This study aims to present the program tools and protocol as a whole, as well as a profile of the incidence, survival, and spatiotemporal distribution of childhood cancer in the region of Murcia, Spain, using 822 sample cases of cancer diagnosed in children under 15 years of age (1998-2020). While the crude incidence rate across that entire period was 149.6 per 1 million, there was an increase over that time in the incidence. The areas with a higher standardized incidence ratio have shifted from the northwest (1998-2003) to the southeast (2016-2020) region. Overall, the ten-year survival rate for all tumor types was 80.1% over the entire period, increasing the five-year survival rate from 76.1 (1998-2003) to 85.5 (2014-2018). CACS living in areas with very poor outdoor air quality had lower survival rates. Furthermore, integrating environmental health into clinical practice could improve knowledge of the etiology and prognosis, as well as the outcomes of CACS. Finally, monitoring individual carbon footprints and creating healthier lifestyles, alongside healthier environments for CACS, could promote wellbeing, environmental awareness, and empowerment in order to attain Sustainable Development Goals for non-communicable diseases in this population.
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Affiliation(s)
- Laura T. Cabrera-Rivera
- European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), Instituto Murciano de Investigación Sanitaria (IMIB), University of Murcia, 30120 Murcia, Spain
- Department of Environmental Health, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00921, USA
- International Exchange Program for Minority Students, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Brittney Sweetser
- European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), Instituto Murciano de Investigación Sanitaria (IMIB), University of Murcia, 30120 Murcia, Spain
- International Exchange Program for Minority Students, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Pediatrics, UC San Diego Health, San Diego, CA 92037, USA
| | - José L. Fuster-Soler
- European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), Instituto Murciano de Investigación Sanitaria (IMIB), University of Murcia, 30120 Murcia, Spain
- Department of Pediatric Hematology & Oncology, Clinical University Hospital Virgen of Arrixaca, 30120 Murcia, Spain
| | - Rebeca Ramis
- European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), Instituto Murciano de Investigación Sanitaria (IMIB), University of Murcia, 30120 Murcia, Spain
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain
| | - Fernando A. López-Hernández
- European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), Instituto Murciano de Investigación Sanitaria (IMIB), University of Murcia, 30120 Murcia, Spain
- Department of Quantitative Methods and Computing, Technical University of Cartagena, 30202 Cartagena, Spain
| | - Antonio Pérez-Martínez
- European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), Instituto Murciano de Investigación Sanitaria (IMIB), University of Murcia, 30120 Murcia, Spain
- Pediatric Onco-Hematology Department, La Paz University Hospital, Translational Research in Pediatric Oncology, Hematopoietic Transplantation, and Cell Therapy, IdiPAZ, Autonomous University of Madrid, 28046 Madrid, Spain
| | - Juan A. Ortega-García
- European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), Instituto Murciano de Investigación Sanitaria (IMIB), University of Murcia, 30120 Murcia, Spain
- International Exchange Program for Minority Students, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Paediatric Environmental Health Specialty Unit, Department of Pediatrics, Clinical University Hospital Virgen of Arrixaca, 30120 Murcia, Spain
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Salvador Bofill J, Moreno Anton F, Rodriguez Sanchez CA, Galve Calvo E, Hernando Melia C, Ciruelos Gil EM, Vidal M, Jiménez-Rodriguez B, De la Cruz Merino L, Martínez Jañez N, Villanueva Vazquez R, de Toro Salas R, Anton Torres A, Alvarez Lopez IM, Gavila Gregori J, Quiroga Garcia V, Vicente Rubio E, De la Haba-Rodriguez J, Gonzalez-Santiago S, Diaz Fernandez N, Barnadas Molins A, Cantos Sanchez de Ibargüen B, Delgado Mingorance JI, Bellet Ezquerra M, de Casa S, Gimeno A, Martin M. Safety and efficacy of ribociclib plus letrozole in patients with HR+, HER2- advanced breast cancer: Results from the Spanish sub-population of the phase 3b CompLEEment-1 trial. Breast 2022; 66:77-84. [PMID: 36206609 PMCID: PMC9535465 DOI: 10.1016/j.breast.2022.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Breast cancer is the most common malignancy and the second leading cause of cancer-related mortality in Spanish women. Ribociclib in combination with endocrine therapy (ET) has shown superiority in prolonging survival in patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) vs. ET alone. METHODS CompLEEment-1 is a single-arm, open-label phase 3b trial evaluating ribociclib plus letrozole in a broad population of patients with HR+, HER2- ABC. The primary endpoints were safety and tolerability. Here we report data for Spanish patients enrolled in CompLEEment-1. RESULTS A total of 526 patients were evaluated (median follow-up: 26.97 months). Baseline characteristics showed a diverse population with a median age of 54 years. At study entry, 56.5% of patients had visceral metastases and 8.7% had received prior chemotherapy for advanced disease. Rates of all-grade and Grade ≥3 adverse events (AEs) were 99.0% and 76.2%, respectively; 21.3% of patients experienced a serious AE, and 15.8% of AEs led to treatment discontinuation. AEs of special interest of neutropenia, increased alanine aminotransferase, increased aspartate aminotransferase and QTcF prolongation occurred in 77.8%, 14.8%, 11.4% and 4.0% of patients, respectively. Patients aged >70 years experienced increased rates of all-grade and Grade ≥3 neutropenia and anemia. Efficacy results were consistent with the global study. CONCLUSIONS Results from Spanish patients enrolled in CompLEEment-1 are consistent with global data showing efficacy and a manageable safety profile for ribociclib plus letrozole treatment in patients with HR+, HER2- ABC, including populations of interest (NCT02941926). TRIAL REGISTRATION ClinicalTrials.gov NCT02941926.
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Affiliation(s)
- Javier Salvador Bofill
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain,Corresponding author. Unidad de Oncología, Servicio de Oncología, Hospital Universitario Virgen del Rocío, Av. Manuel Siurot, s/n, 41013 Sevilla, Spain.
| | | | | | | | - Cristina Hernando Melia
- Servicio de Oncología, Hospital Clínico Universitario de Valencia e Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
| | | | - Maria Vidal
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | - Vanesa Quiroga Garcia
- Departamento de Oncología, Badalona-Applied Research Group in Oncology (B-ARGO Group), Institut Català d’Oncologia, Badalona, Spain
| | | | - Juan De la Haba-Rodriguez
- Instituto Maimonides de Investigacion Biomedica (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba, Spain
| | | | | | - Agusti Barnadas Molins
- Hospital Universitari Santa Creu i Sant Pau and CIBERONC Breast Cancer Programme, Department of Medicine, Universitat Autonoma Barcelona, Barcelona, Spain
| | | | | | - Meritxell Bellet Ezquerra
- Hospital Universitari Vall d’Hebron, Barcelona and Institut Oncològic Vall d’Hebron (VHIO), Barcelona, Spain
| | | | | | - Miguel Martin
- Hospital Universitario Gregorio Marañón, Madrid, Spain
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Prieto-Potin I, Idrovo F, Suárez-Gauthier A, Díaz-Blázquez M, Astilleros-Blanco de Córdova L, Chamizo C, Zazo S, Carvajal N, López-Sánchez A, Pérez-Buira S, Aúz-Alexandre CL, Manso R, Plaza-Sánchez J, de Lucas-López V, Pérez-González N, Martín-Valle S, Cristóbal I, Casado V, García-Foncillas J, Rojo F. Comprehensive Approach to Genomic and Immune Profiling: Insights of a Real-World Experience in Gynecological Tumors. Diagnostics (Basel) 2022; 12:diagnostics12081903. [PMID: 36010253 PMCID: PMC9406465 DOI: 10.3390/diagnostics12081903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/22/2022] [Accepted: 08/03/2022] [Indexed: 11/25/2022] Open
Abstract
Gynecological cancer accounts for an elevated incidence worldwide requiring responsiveness regarding its care. The comprehensive genomic approach agrees with the classification of certain tumor types. We evaluated 49 patients with gynecological tumors undergoing high-throughput sequencing to explore whether identifying alterations in cancer-associated genes could characterize concrete histological subtypes. We performed immune examination and analyzed subsequent clinical impact. We found 220 genomic aberrations mostly distributed as single nucleotide variants (SNV, 77%). Only 3% were classified as variants of strong clinical significance in BRCA1 and BRCA2 of ovarian high-grade serous (HGSC) and uterine endometrioid carcinoma. TP53 and BRCA1 occurred in 72% and 28% of HGSC. Cervical squamous cell carcinoma was entirely HPV-associated and mutations occurred in PIK3CA (60%), as well as in uterine serous carcinoma (80%). Alterations were seen in PTEN (71%) and PIK3CA (60%) of uterine endometrioid carcinoma. Elevated programmed death-ligand 1 (PD-L1) was associated with high TILs. Either PD-L1 augmented in deficient mis-matched repair (MMR) proteins or POLE mutated cases when compared to a proficient MMR state. An 18% received genotype-guided therapy and a 4% immunotherapy. The description of tumor subtypes is plausible through high-throughput sequencing by recognizing clinically relevant alterations. Additional concomitant assessment of immune biomarkers identifies candidates for immunotherapy.
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Affiliation(s)
- Iván Prieto-Potin
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Franklin Idrovo
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Ana Suárez-Gauthier
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - María Díaz-Blázquez
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | | | - Cristina Chamizo
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Sandra Zazo
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Nerea Carvajal
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Almudena López-Sánchez
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Sandra Pérez-Buira
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Carmen Laura Aúz-Alexandre
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Rebeca Manso
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Jenifer Plaza-Sánchez
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Virginia de Lucas-López
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Nuria Pérez-González
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Sara Martín-Valle
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Ion Cristóbal
- Cancer Unit for Research on Novel Therapeutic Targets, Oncohealth Institute, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
- Translational Oncology Division, Oncohealth Institute, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Victoria Casado
- Translational Oncology Division, Oncohealth Institute, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Jesús García-Foncillas
- Cancer Unit for Research on Novel Therapeutic Targets, Oncohealth Institute, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
- Translational Oncology Division, Oncohealth Institute, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
| | - Federico Rojo
- Department of Pathology, CIBERONC, UAM, Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
- Correspondence:
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21
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Sanchez L, Fernandez N, Calle AP, Ladera V, Casado I, Bayon E, Garcia I, Sahagun AM. Assessing the Expression of Emotions in Breast Cancer Survivors during the Time of Recovery: Perspective from Focus Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9672. [PMID: 35955033 PMCID: PMC9368609 DOI: 10.3390/ijerph19159672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/30/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Breast cancer has major public health implications, as it is the most frequent malignant tumor and the leading cause of cancer death in women. Survivors have many needs, including strategies to cope with the associated distress. We explore whether focus groups are useful for nurses to obtain information about the emotional state of breast cancer women, and develop strategies for coping with the stress that this disease entails. A qualitative study was carried out, involving 25 focus groups with 83 women treated for breast cancer, recruited from the local Breast Cancer Association (ALMOM). Four open-ended questions were employed, and 60-min discussions were carried out. They were transcribed, analyzed, coded, and the themes identified. Four major themes emerged, including "complex emotional evolution", "emotional isolation", "lack of information" and "inability to give advice". Women admitted that this disease had been a stressful factor for them, causing emotional (anxiety, irritability, anger or guilt) and cognitive disorders (confusion, lack of concentration, forgetfulness). The use of focus groups in breast cancer survivors allows nurses to evaluate the expression of emotions in these women, and collect and share information about their feelings, thoughts and experiences, so that survivors can cope more easily with the stress related to their illness.
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Affiliation(s)
- Leticia Sanchez
- Department of Nursing and Physical Therapy, Faculty of Nursing, University of Leon, 24071 Leon, Spain
| | - Nelida Fernandez
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), Faculty of Nursing, University of Leon, 24071 Leon, Spain
| | - Angela P. Calle
- Department of Nursing and Physical Therapy, Faculty of Nursing, University of Leon, 24071 Leon, Spain
| | - Valentina Ladera
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, 37005 Salamanca, Spain
| | - Ines Casado
- Department of Nursing and Physical Therapy, Faculty of Nursing, University of Leon, 24071 Leon, Spain
| | - Enrique Bayon
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), Faculty of Nursing, University of Leon, 24071 Leon, Spain
| | - Isaias Garcia
- Department of Electrical and Systems Engineering. University of Leon, 24071 Leon, Spain
| | - Ana M. Sahagun
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), Faculty of Nursing, University of Leon, 24071 Leon, Spain
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Guevara M, Molinuevo A, Salmerón D, Marcos-Gragera R, Carulla M, Chirlaque MD, Rodríguez Camblor M, Alemán A, Rojas D, Vizcaíno Batllés A, Chico M, Jiménez Chillarón R, López de Munain A, de Castro V, Sánchez MJ, Ramalle-Gómara E, Franch P, Galceran J, Ardanaz E. Cancer Survival in Adults in Spain: A Population-Based Study of the Spanish Network of Cancer Registries (REDECAN). Cancers (Basel) 2022; 14:cancers14102441. [PMID: 35626046 PMCID: PMC9139549 DOI: 10.3390/cancers14102441] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary We studied cancer survival and its trends in adult patients in Spain. We included more than 600,000 patients with primary cancer diagnosed during 2002–2013 and followed them up to 2015. The study provides cancer survival estimates up to five years after diagnosis by sex and age for 29 cancer groups. We found survival improvements for most cancer groups from 2002–2007 to 2008–2013, although with differences by age, being greater for patients younger than 75 years than for older patients. The persistent poor prognosis for some cancers emphasizes the need to reinforce actions along the cancer continuum, from primary prevention to early diagnosis, optimal treatment, and supportive care. Further examination of possible sociodemographic inequalities is warranted. Abstract The assessment of cancer survival at the population level is essential for monitoring progress in cancer control. We aimed to assess cancer survival and its trends in adults in Spain. Individual records of 601,250 adults with primary cancer diagnosed during 2002–2013 and followed up to 2015 were included from 13 population-based cancer registries. We estimated net survival up to five years after diagnosis and analyzed absolute changes between 2002–2007 and 2008–2013. Estimates were age-standardized. Analyses were performed for 29 cancer groups, by age and sex. Overall, age-standardized five-year net survival was higher in women (61.7%, 95% CI 61.4–62.1%) than in men (55.3%, 95% CI 55.0–55.6%), and ranged by cancer from 7.2% (pancreas) to 89.6% (prostate) in men, and from 10.0% (pancreas) to 93.1% (thyroid) in women in the last period. Survival declined with age, showing different patterns by cancer. Between both periods, age-standardized five-year net survival increased overall by 3.3% (95% CI 3.0–3.7%) in men and 2.5% (95% CI 2.0–3.0%) in women, and for most cancer groups. Improvements were greater in patients younger than 75 years than in older patients. Chronic myeloid leukemia and myeloma showed the largest increases. Among the most common malignancies, the greatest absolute increases in survival were observed for colon (5.0%, 95% CI 4.0–6.0%) and rectal cancers (4.5%, 95% CI 3.2–5.9%). Survival improved even for some cancers with poor prognosis (pancreas, esophagus, lung, liver, and brain cancer). Further investigation of possible sociodemographic inequalities is warranted. This study contributes to the evaluation of cancer control and health services’ effectiveness.
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Affiliation(s)
- Marcela Guevara
- Navarra Public Health Institute, 31003 Pamplona, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (D.S.); (R.M.-G.); (M.-D.C.); (M.-J.S.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
- Correspondence:
| | - Amaia Molinuevo
- Biodonostia Health Research Institute, 20014 San Sebastian, Spain;
| | - Diego Salmerón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (D.S.); (R.M.-G.); (M.-D.C.); (M.-J.S.)
- Departamento de Ciencias Sociosanitarias, IMIB-Arrixaca, Universidad de Murcia, 30100 Murcia, Spain
| | - Rafael Marcos-Gragera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (D.S.); (R.M.-G.); (M.-D.C.); (M.-J.S.)
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Department of Health, Government of Catalonia, 17007 Girona, Spain
- Descriptive Epidemiology, Genetics and Cancer Prevention Research Group, Girona Biomedical Research Institute (IdiBGi), 17190 Girona, Spain
- Faculty of Medicine, University of Girona, 17071 Girona, Spain
- Josep Carreras Leukemia Research Institute, 17003 Girona, Spain
| | - Marià Carulla
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Hospital Universitari Sant Joan de Reus, CatSalut, 43204 Reus, Spain; (M.C.); (J.G.)
- Pere Virgili Health Research Institute (IISPV), 43204 Reus, Spain
- Faculty of Medicine and Health Sciences, Rovira i Virgili University, 43204 Reus, Spain
| | - María-Dolores Chirlaque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (D.S.); (R.M.-G.); (M.-D.C.); (M.-J.S.)
- Departamento de Ciencias Sociosanitarias, IMIB-Arrixaca, Universidad de Murcia, 30100 Murcia, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, 30008 Murcia, Spain
| | | | - Araceli Alemán
- Canary Islands Cancer Registry, Public Health Directorate, Canary Health Service, 35003 Las Palmas de Gran Canaria, Spain; (A.A.); (D.R.)
| | - Dolores Rojas
- Canary Islands Cancer Registry, Public Health Directorate, Canary Health Service, 35003 Las Palmas de Gran Canaria, Spain; (A.A.); (D.R.)
| | - Ana Vizcaíno Batllés
- Castellón Cancer Registry, Public Health Directorate, General Health Department, Generalitat Valenciana, 46020 Valencia, Spain;
| | - Matilde Chico
- Ciudad Real Cancer Registry, Health and Social Welfare Authority, Castile-La Mancha, 13071 Ciudad Real, Spain;
| | - Rosario Jiménez Chillarón
- Cuenca Cancer Registry, Health and Social Welfare Authority, Castile-La Mancha, 16071 Cuenca, Spain;
| | - Arantza López de Munain
- Basque Country Cancer Registry, Health Department, 01010 Vitoria, Spain; (A.L.d.M.); (V.d.C.)
| | - Visitación de Castro
- Basque Country Cancer Registry, Health Department, 01010 Vitoria, Spain; (A.L.d.M.); (V.d.C.)
| | - Maria-José Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (D.S.); (R.M.-G.); (M.-D.C.); (M.-J.S.)
- Escuela Andaluza de Salud Pública (EASP), 18011 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain
| | - Enrique Ramalle-Gómara
- Department of Epidemiology and Prevention, La Rioja Regional Health Authority, 26071 Logroño, Spain;
| | - Paula Franch
- Balearic Islands Health Research Institute (IdISBa), Illes Balears, 07120 Palma, Spain;
- Mallorca Cancer Registry, Balearic Islands Public Health Department, 07010 Palma, Spain
| | - Jaume Galceran
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Hospital Universitari Sant Joan de Reus, CatSalut, 43204 Reus, Spain; (M.C.); (J.G.)
- Pere Virgili Health Research Institute (IISPV), 43204 Reus, Spain
- Faculty of Medicine and Health Sciences, Rovira i Virgili University, 43204 Reus, Spain
| | - Eva Ardanaz
- Navarra Public Health Institute, 31003 Pamplona, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (D.S.); (R.M.-G.); (M.-D.C.); (M.-J.S.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
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Nagore E, Moreno-Ramírez D, Ortiz-Romero P, Martín-Sánchez E, Martínez-Fernández A, Puig S. [Translated article] Epidemiology of Melanoma in Spain: Estimation of Number of Patients With Stage III Disease Eligible for Adjuvant Therapies. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Nagore E, Moreno-Ramírez D, Ortiz-Romero P, Martín-Sánchez E, Martínez-Fernández A, Puig S. Epidemiology of Melanoma in Spain: Estimation of Number of Patients With Stage III Disease Eligible for Adjuvant Therapies. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:354-362. [PMID: 35623725 DOI: 10.1016/j.ad.2021.11.003] [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: 06/17/2021] [Revised: 09/27/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Accurate information on the incidence of melanoma by stage and a better understanding of transition between stages are important for determining the burden of disease and assessing the impact of new adjuvant therapies on recurrence and survival. The aim of this study was to estimate the incidence rates of the various stages of melanoma in Spain and to estimate the number of patients with stage III disease who are eligible for adjuvant systemic therapies. MATERIALS AND METHOD We built an epidemiological model using prospectively collected data from patients diagnosed with de novo or recurrent melanoma between 2012 and 2016 in the melanoma units of 4 public hospitals. RESULTS The estimated crude incidence rates for stage I and II melanoma were 7 and 2.9 cases per 100,000 person-years, respectively. The corresponding rates for stage III and IV melanoma were 1.9 and 1.3 cases per 100,000 person-years; 25.8% of patients with stage III melanoma were stage IIIA, 47% were stage IIIB, and 27.3% were stage IIIC. The respective estimated incidence rates for recurrent stage III and IV melanoma were 1.1 and 0.9 cases per 100,000 person-years. Overall, 54% of patients with recurrent stage III melanoma had progressed from stage I or II; the other cases corresponded to changes in substage. Of the patients with stage III melanoma, 85% of those with a de novo diagnosis and 80% of those who had relapsed had resectable disease, meaning they were eligible for adjuvant therapy; 47% of these patients had a BRAF mutation. CONCLUSIONS The above estimates could have a major impact on health care resource planning. Assessing the number of patients with melanoma who are eligible for adjuvant therapies in melanoma could help decision-makers and clinicians anticipate future needs for the management of this disease.
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Affiliation(s)
- E Nagore
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España.
| | - D Moreno-Ramírez
- Servicio de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - P Ortiz-Romero
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - E Martín-Sánchez
- Departamento de Acceso al Mercado, Novartis Farmacéutica S.A., Barcelona, España
| | | | - S Puig
- Servicio de Dermatología, Hospital Universitari Clínic, Barcelona, España
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Blay Aulina L, Louro Aldamiz-Echevarría J, Ribes Cajas P, Pascual Miguel I, Mitkova Borisova I, Sanchez Haro E, Luna Tomás M, Ríos Gozalvez C, Parrales Mora M, Pares Martínez D, Sala Serra M, Julian Ibañez J. Cáncer de mama en pacientes octogenarias. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2022. [DOI: 10.1016/j.gine.2021.100722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rodríguez-Palacios DÁ, Colorado-Yohar SM, Velten M, Vaamonde-Martín RJ, Ballesta M, Chirlaque MD. Incidence and Trend of Type I and II Endometrial Cancer in Women from Two Population-Based European Cancer Registries (1998-2012). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073789. [PMID: 35409473 PMCID: PMC8997612 DOI: 10.3390/ijerph19073789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/09/2022] [Accepted: 03/20/2022] [Indexed: 01/02/2023]
Abstract
Endometrial cancer (EC) is the most frequent female genital tract cancer in Europe. This cohort study aimed to determine age-standardised incidence rates and long-term trends of type I and II endometrial cancer in women from population-based cancer registries in the Region of Murcia (Spain) and the Bas-Rhin area (France). Data of new cases of endometrial cancer between 1998 and 2012 were obtained from the Murcia and Bas-Rhin cancer registries. In that period, 3756 cases of endometrial cancer were recorded, with 3270 corresponding to type I EC and 486 corresponding to type II EC. The Bas-Rhin area presented higher age-adjusted incidence rates than those in the Region of Murcia for both type I EC (24.2 and 19.3 cases/100,000 person-years (py), respectively) and type II EC (4.4 and 2.3 cases/100,000 py, respectively). Joinpoint regression showed no changes in trends. In both populations, there was an increasing trend for both EC types, but the trend was steeper in the Region of Murcia and larger overall for type II EC. Finally, a significant increase was observed in the annual trend of type II EC. Further studies are warranted to determine the potential risk factors, and continued efforts are needed to improve the recording and monitoring of EC types.
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Affiliation(s)
| | - Sandra M. Colorado-Yohar
- Department of Epidemiology, Murcia Regional Health Council, Ronda de Levante, 11, 30008 Murcia, Spain; (R.J.V.-M.); (M.B.); (M.-D.C.)
- CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Avenida Monforte de Lemos 3-5, 28029 Madrid, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Calle 62 No. 52–59, Medellín 050010, Colombia
- Biomedical Research Institute (IMIB-Arrixaca), El Palmar, 30120 Murcia, Spain
- Correspondence:
| | - Michel Velten
- Department of Epidemiology and Public Health, Bas-Rhin Cancer Registry, Inserm UMR-S1113, ICANS, University of Strasbourg, 67085 Strasbourg, France;
| | - Ricardo J. Vaamonde-Martín
- Department of Epidemiology, Murcia Regional Health Council, Ronda de Levante, 11, 30008 Murcia, Spain; (R.J.V.-M.); (M.B.); (M.-D.C.)
- Biomedical Research Institute (IMIB-Arrixaca), El Palmar, 30120 Murcia, Spain
| | - Mónica Ballesta
- Department of Epidemiology, Murcia Regional Health Council, Ronda de Levante, 11, 30008 Murcia, Spain; (R.J.V.-M.); (M.B.); (M.-D.C.)
- Biomedical Research Institute (IMIB-Arrixaca), El Palmar, 30120 Murcia, Spain
- Department of Health and Social Sciences, University of Murcia, Campus de Espinardo, 30100 Murcia, Spain
| | - María-Dolores Chirlaque
- Department of Epidemiology, Murcia Regional Health Council, Ronda de Levante, 11, 30008 Murcia, Spain; (R.J.V.-M.); (M.B.); (M.-D.C.)
- CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Avenida Monforte de Lemos 3-5, 28029 Madrid, Spain
- Biomedical Research Institute (IMIB-Arrixaca), El Palmar, 30120 Murcia, Spain
- Department of Health and Social Sciences, University of Murcia, Campus de Espinardo, 30100 Murcia, Spain
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Next step in molecular genetics of hereditary breast/ovarian cancer: Multigene panel testing in clinical actionably genes and prioritization algorithms in the study of variants of uncertain significance. Eur J Med Genet 2022; 65:104468. [PMID: 35245693 DOI: 10.1016/j.ejmg.2022.104468] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 01/15/2022] [Accepted: 02/25/2022] [Indexed: 02/06/2023]
Abstract
INTRODUCTION BRCA1 and BRCA2 are the two main genes causing hereditary breast and ovarian cancer (HBOC). However, thanks to the development of Next Generation Sequencing (NGS), other genes linked to this syndrome (CHEK2, BRIP1, ATM and PALB2 among others) can be analysed. MATERIAL AND METHODS an analysis by multigene panel testing was performed in 138 index cases (ICs) from HBOC Spanish families with a previous non-informative result for BRCA1/2. The BRCA Hereditary Cancer Master™ Plus kit, including 26 actionable and candidate genes related to HBOC was employed. Once classified, an algorithm was employed to prioritized those variants of unknown significance with a higher risk of having a deleterious effect. Moreover, a mRNA splicing assay was performed for the prioritized VUS c.3402+3A > C in ATM, located at intron 23. RESULTS A total of 82 variants were found: 70 VUS and 12 pathogenic or probably pathogenic variants. The diagnostic yield in actionable genes non-BRCA was 7.97% of the total tested ICs. Overall, 19 VUS were prioritized, which meant 27% of the 70 total VUS. RNA analysis of the variant 3402+3A > C confirmed a deleterious impact on splicing. DISCUSSION The implementation of a multigene panel in HBOC studied families improved the diagnostic yield, concordant with results obtained in previous publications. Due to the important number of VUS obtained in NGS, the application of a prioritization algorithm is needed in order to select those variants in which it is necessary to conduct further studies.
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Pineño-Flores C, Ambrona-Zafra D, Rodríguez-Pino JC, Soldevila-Verdeguer C, Palma-Zamora E, Molina-Romero FX, Morón-Canis JM, González-Argente FX, Morales-Soriano R. Cephalic pancreaticoduodenectomy for ductal adenocarcinoma in the elderly. Can we do it safely? Cir Esp 2022; 100:125-132. [PMID: 35221240 DOI: 10.1016/j.cireng.2022.02.011] [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: 08/29/2020] [Accepted: 01/17/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Surgery and chemotherapy have increased the survival of pancreatic cancer. The decrease in postoperative morbidity and mortality and increase in life expectancy, has expanded the indications por cephalic pancreaticoduodenectomy (PDC), although it remains controversial in the geriatric population. METHODS Retrospective study on a prospective database of patients with ductal adenocarcinoma of pancreas who underwent PDC between 2007-2018. The main objective was to analyse the morbidity-mortality and survival associated with PDC in patients ≥75 years (elderly). RESULTS 79 patients were included, 21 of them older than 75 years (27%); within this group, 23'9% were over 80 years old. The ASA of both groups was similar. Patients ≥75 years required more transfusions. No differences in operating time were observed, although more vascular resection were performed in the elderly (26 vs. 8.7%; P = .037). Morbidity was higher in the elderly (61.9% vs. 46.6%), although without differences. Patients aged ≥75 years had more non-surgical complications (33.3%, P = .050), being pneumonia the most frequent. Postoperative mortality was higher in the ≥75 years (9 vs. 0%; P = .017). The overall survival and disease-free survival did not show significant differences in both groups. CONCLUSIONS Elderly patients had higher postoperative mortality and more non-surgical complications. Survival did not show differences, so with an adequate selection of patients, age should not be considered itself as a contraindication for PDC.
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Affiliation(s)
- Cristina Pineño-Flores
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Instituto de Investigación Sanitaria de Islas Baleares (IdISBa), Hospital Universitari Arnau de Villanova, Palma de Mallorca, Balearic Islands, Spain.
| | - David Ambrona-Zafra
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Arnau de Vilanova, Lleida, Catalonia, Spain
| | - Jose Carlos Rodríguez-Pino
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain
| | - Carla Soldevila-Verdeguer
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Instituto de Investigación Sanitaria de Islas Baleares (IdISBa), Hospital Universitari Arnau de Villanova, Palma de Mallorca, Balearic Islands, Spain
| | - Elias Palma-Zamora
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain
| | - Francesc Xavier Molina-Romero
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Instituto de Investigación Sanitaria de Islas Baleares (IdISBa), Hospital Universitari Arnau de Villanova, Palma de Mallorca, Balearic Islands, Spain; Facultad de Medicina, Universidad de las Islas Baleares, Palma de Mallorca, Balearic Islands, Spain
| | - Jose Miguel Morón-Canis
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain
| | - Francesc Xavier González-Argente
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Instituto de Investigación Sanitaria de Islas Baleares (IdISBa), Hospital Universitari Arnau de Villanova, Palma de Mallorca, Balearic Islands, Spain; Facultad de Medicina, Universidad de las Islas Baleares, Palma de Mallorca, Balearic Islands, Spain
| | - Rafael Morales-Soriano
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Instituto de Investigación Sanitaria de Islas Baleares (IdISBa), Hospital Universitari Arnau de Villanova, Palma de Mallorca, Balearic Islands, Spain
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Peremiquel-Trillas P, Frias-Gomez J, Alemany L, Ameijide A, Vilardell M, Marcos-Gragera R, Paytubi S, Ponce J, Martínez JM, Pineda M, Brunet J, Matías-Guiu X, Carulla M, Galceran J, Izquierdo Á, Borràs JM, Costas L, Clèries R. Predicting Ovarian-Cancer Burden in Catalonia by 2030: An Age-Period-Cohort Modelling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031404. [PMID: 35162436 PMCID: PMC8834772 DOI: 10.3390/ijerph19031404] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 02/01/2023]
Abstract
Ovarian cancer is the most lethal gynaecological cancer in very-high-human-development-index regions. Ovarian cancer incidence and mortality rates are estimated to globally rise by 2035, although incidence and mortality rates depend on the region and prevalence of the associated risk factors. The aim of this study is to assess changes in incidence and mortality of ovarian cancer in Catalonia by 2030. Bayesian autoregressive age–period–cohort models were used to predict the burden of OC incidence and mortality rates for the 2015–2030 period. Incidence and mortality rates of ovarian cancer are expected to decline in Catalonia by 2030 in women ≥ 45 years of age. A decrease in ovarian-cancer risk was observed with increasing year of birth, with a rebound in women born in the 1980s. A decrease in mortality was observed for the period of diagnosis and period of death. Nevertheless, ovarian-cancer mortality remains higher among older women compared to other age groups. Our study summarizes the most plausible scenario for ovarian-cancer changes in terms of incidence and mortality in Catalonia by 2030, which may be of interest from a public health perspective for policy implementation.
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Affiliation(s)
- Paula Peremiquel-Trillas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (J.F.-G.); (L.A.); (S.P.)
- Bellvitge Biomedical Research Institute-IDIBELL, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.P.); (J.M.M.); (J.B.); (X.M.-G.); (J.M.B.)
- Faculty of Medicine, University of Barcelona, C/Casanova 143, 08036 Barcelona, Spain
| | - Jon Frias-Gomez
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (J.F.-G.); (L.A.); (S.P.)
- Bellvitge Biomedical Research Institute-IDIBELL, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.P.); (J.M.M.); (J.B.); (X.M.-G.); (J.M.B.)
- Faculty of Medicine, University of Barcelona, C/Casanova 143, 08036 Barcelona, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (J.F.-G.); (L.A.); (S.P.)
- Bellvitge Biomedical Research Institute-IDIBELL, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.P.); (J.M.M.); (J.B.); (X.M.-G.); (J.M.B.)
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029 Madrid, Spain;
| | - Alberto Ameijide
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Sant Joan de Reus University Hospital, Av. Dr. Josep Laporte 2, 43204 Reus, Spain; (A.A.); (M.C.); (J.G.)
- Pere Virgili Health Research Institute-IISPV, Rovira i Virgili University, Av. de la Universitat, 1, 2ª pl. Reus, 43204 Tarragona, Spain
| | | | - Rafael Marcos-Gragera
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029 Madrid, Spain;
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Department of Health, Government of Catalonia, Av. França-Sant Ponç s/n, 17007 Girona, Spain;
- Descriptive Epidemiology, Genetics and Cancer Prevention Research Group, Girona Biomedical Research Institute-IDIBGI. C/Dr. Castany s/n. Edifici M2, Parc Hospitalari Martí i Julià, 17190 Salt, Spain
- Medical Sciences Department, Faculty of Medicine, University of Girona, C/Emili Grahit 77, 17071 Girona, Spain
| | - Sònia Paytubi
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (J.F.-G.); (L.A.); (S.P.)
- Bellvitge Biomedical Research Institute-IDIBELL, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.P.); (J.M.M.); (J.B.); (X.M.-G.); (J.M.B.)
| | - Jordi Ponce
- Bellvitge Biomedical Research Institute-IDIBELL, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.P.); (J.M.M.); (J.B.); (X.M.-G.); (J.M.B.)
- Department of Gynecology and Obstetrics, Bellvitge University Hospital, Feixa Llarga s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - José Manuel Martínez
- Bellvitge Biomedical Research Institute-IDIBELL, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.P.); (J.M.M.); (J.B.); (X.M.-G.); (J.M.B.)
- Department of Gynecology and Obstetrics, Bellvitge University Hospital, Feixa Llarga s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Marta Pineda
- Hereditary Cancer Programme, Catalan Institute of Oncology, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
| | - Joan Brunet
- Bellvitge Biomedical Research Institute-IDIBELL, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.P.); (J.M.M.); (J.B.); (X.M.-G.); (J.M.B.)
- Hereditary Cancer Programme, Catalan Institute of Oncology, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
- Consortium for Biomedical Research in Cancer-CIBERONC, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029 Madrid, Spain
- Medical Oncology Department, Catalan Institute of Oncology, Doctor Josep Trueta Girona University Hospital, Av. França-Sant Ponç s/n, 17007 Girona, Spain
| | - Xavier Matías-Guiu
- Bellvitge Biomedical Research Institute-IDIBELL, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.P.); (J.M.M.); (J.B.); (X.M.-G.); (J.M.B.)
- Consortium for Biomedical Research in Cancer-CIBERONC, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029 Madrid, Spain
- Department of Pathology, Bellvitge University Hospital, Feixa Llarga s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Marià Carulla
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Sant Joan de Reus University Hospital, Av. Dr. Josep Laporte 2, 43204 Reus, Spain; (A.A.); (M.C.); (J.G.)
- Pere Virgili Health Research Institute-IISPV, Rovira i Virgili University, Av. de la Universitat, 1, 2ª pl. Reus, 43204 Tarragona, Spain
| | - Jaume Galceran
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Sant Joan de Reus University Hospital, Av. Dr. Josep Laporte 2, 43204 Reus, Spain; (A.A.); (M.C.); (J.G.)
- Pere Virgili Health Research Institute-IISPV, Rovira i Virgili University, Av. de la Universitat, 1, 2ª pl. Reus, 43204 Tarragona, Spain
| | - Ángel Izquierdo
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Department of Health, Government of Catalonia, Av. França-Sant Ponç s/n, 17007 Girona, Spain;
- Hereditary Cancer Programme, Catalan Institute of Oncology, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
- Medical Oncology Department, Catalan Institute of Oncology, Doctor Josep Trueta Girona University Hospital, Av. França-Sant Ponç s/n, 17007 Girona, Spain
- Statistical Section, Genetics, Microbiology and Statistics Department, Faculty of Biology, University of Barcelona, Av. Diagonal 643, 08028 Barcelona, Spain
| | - Josep M. Borràs
- Bellvitge Biomedical Research Institute-IDIBELL, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.P.); (J.M.M.); (J.B.); (X.M.-G.); (J.M.B.)
- Oncology Coordination Plan, Catalan Institute of Oncology, Department of Health, Government of Catalonia, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Laura Costas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (P.P.-T.); (J.F.-G.); (L.A.); (S.P.)
- Bellvitge Biomedical Research Institute-IDIBELL, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.P.); (J.M.M.); (J.B.); (X.M.-G.); (J.M.B.)
- Consortium for Biomedical Research in Epidemiology and Public Health-CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029 Madrid, Spain;
- Correspondence: (L.C.); (R.C.); Tel.: +34-93-260-78-12 or +34-93-260-32-10 (L.C.); +34-93-260-74-17 (R.C.)
| | - Ramon Clèries
- Bellvitge Biomedical Research Institute-IDIBELL, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (J.P.); (J.M.M.); (J.B.); (X.M.-G.); (J.M.B.)
- Oncology Coordination Plan, Catalan Institute of Oncology, Department of Health, Government of Catalonia, Av. Gran Vía 199-203, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Clinical Sciences Department, Faculty of Medicine, University of Barcelona, Feixa Llarga s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Correspondence: (L.C.); (R.C.); Tel.: +34-93-260-78-12 or +34-93-260-32-10 (L.C.); +34-93-260-74-17 (R.C.)
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Piekarska K, Zacharczuk K, Wołkowicz T, Mokrzyś M, Wolaniuk N, Nowakowska M, Szempliński S, Dobruch J, Gierczyński R. The molecular mechanisms of fluoroquinolone resistance found in rectal swab isolates of Enterobacterales from men undergoing a transrectal prostate biopsy: the rationale for targeted prophylaxis. Ann Clin Microbiol Antimicrob 2021; 20:81. [PMID: 34876123 PMCID: PMC8650336 DOI: 10.1186/s12941-021-00487-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/22/2021] [Indexed: 01/29/2023] Open
Abstract
Background Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is considered an essential urological procedure for the histological diagnosis of prostate cancer. It is, however, considered a “contaminated” procedure which may lead to infectious complications. Recent studies suggest a significant share of fluoroquinolone-resistant rectal flora in post-biopsy infections. Methods The molecular mechanisms of fluoroquinolone resistance, including PMQR (plasmid-mediated quinolone resistance) as well as mutation in the QRDRs (quinolone-resistance determining regions) of gyrA, gyrB, parC and parE, among Enterobacterales isolated from 32 of 48 men undergoing a prostate biopsy between November 2015 and April 2016 were investigated. Before the TRUS-Bx procedure, all the patients received an oral antibiotic containing fluoroquinolones. Results In total, 41 Enterobacterales isolates were obtained from rectal swabs. The MIC of ciprofloxacin and the presence of common PMQR determinants were investigated in all the isolates. Nine (21.9%) isolates carried PMQR with qnrS as the only PMQR agent detected. DNA sequencing of the QRDRs in 18 Enterobacterales (E. coli n = 17 and E. cloacae n = 1) isolates with ciprofloxacin MIC ≥ 0.25 mg/l were performed. Substitutions in the following codons were found: GyrA—83 [Ser → Leu, Phe] and 87 [Asp → Asn]; GyrB codon—605 [Met → Leu], ParC codons—80 [Ser → Ile, Arg] and 84 [Glu → Gly, Met, Val, Lys], ParE codons—458 [Ser → Ala], 461 [Glu → Ala] and 512 [Ala → Thr]. Six isolates with ciprofloxacin MIC ≥ 2 mg/l had at least one mutation in GyrA together with qnrS. Conclusions This study provides information on the common presence of PMQRs among Enterobacterales isolates with ciprofloxacin MIC ≥ 0.25 mg/l, obtained from men undergoing TRUS-Bx. This fact may partially explain why some men develop post-TRUS-Bx infections despite ciprofloxacin prophylaxis.
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Affiliation(s)
- Katarzyna Piekarska
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland.
| | - Katarzyna Zacharczuk
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland
| | - Tomasz Wołkowicz
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland
| | - Mateusz Mokrzyś
- Department of Urology, St. Anna Hospital, A. Mickiewicza 39, 05-500, Piaseczno, Poland.,Department of Urology, Centre of Postgraduate Medical Education, 01-813, Warsaw, Poland
| | - Natalia Wolaniuk
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland
| | - Magdalena Nowakowska
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland
| | - Stanisław Szempliński
- Department of Urology, Centre of Postgraduate Medical Education, 01-813, Warsaw, Poland
| | - Jakub Dobruch
- Department of Urology, St. Anna Hospital, A. Mickiewicza 39, 05-500, Piaseczno, Poland.,Department of Urology, Centre of Postgraduate Medical Education, 01-813, Warsaw, Poland
| | - Rafał Gierczyński
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland
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Sobrino-Reig E, Meizoso T, García J, Varillas-Delgado D, Martin YB. Morphological predictors for microsatellite instability in urothelial carcinoma. Diagn Pathol 2021; 16:106. [PMID: 34801034 PMCID: PMC8606048 DOI: 10.1186/s13000-021-01168-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Microsatellite instability occurs due to a series of mutations in the DNA pairing error repair (Mismatch repair; MMR) genes, which can affect germ cells as occurs in Lynch syndrome, whose patients are at high risk of developing multiple cancers. The loss of MMR protein is commonly determined by immunohistochemical studies. Although the relation between microsatellite instability and urothelial carcinomas has been widely studied, its evaluation is not currently performed in the analysis of urothelial carcinomas. Methods In this study, the microsatellite status of 139 urothelial carcinomas was analyzed and their clinicopathological characteristics were evaluated. We identified that 10.3% (13 patients) of urothelial carcinomas had loss of MMR protein expression (9 MLH1; 5 MSH2; 2 PMS2; 2 PSH6; n = 139). Results Results suggest that these tumors occur more frequently in males, are more frequently located in the bladder or ureters, and present a high tumor grade with a papillary histological pattern that does not infiltrate the lamina propria or, in the case of infiltrating tumors, that grows into perivesical tissues. Conclusions We identified patients with the aforementioned tumor characteristics as patients with a high probability of presenting loss of MMR protein expression, and consider that only these patients should undergo further immunohistochemical and molecular techniques for proper diagnosis. Therefore, we propose that the clinicopathological characteristics found in the present study could become possible markers to determine which cases should undergo additional tests.
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Affiliation(s)
| | - Telma Meizoso
- Hospital Universitario de Móstoles, Móstoles, Madrid, Spain.,Facultad de Medicina, Universidad Francisco de Vitoria, 28223, Pozuelo de Alarcón, Madrid, Spain
| | - Jesús García
- Hospital Universitario de Móstoles, Móstoles, Madrid, Spain.,Facultad de Medicina, Universidad Francisco de Vitoria, 28223, Pozuelo de Alarcón, Madrid, Spain
| | - David Varillas-Delgado
- Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Yasmina B Martin
- Facultad de Medicina, Universidad Francisco de Vitoria, 28223, Pozuelo de Alarcón, Madrid, Spain.
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Rosas I, Morís G, Coto E, Blázquez M, Suárez E, García-Fernández C, Siso P, Martínez C, Pérez-Oliveira S, Álvarez V, Menéndez-González M. Cancer in Parkinson's Disease: An Approximation to the Main Risk Factors. NEURODEGENER DIS 2021; 21:36-41. [PMID: 34673649 DOI: 10.1159/000520301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/18/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Many evidences suggest a pathological link between neurodegenerative diseases and cancer. In fact, several epidemiologic studies indicate a decreased incidence of most cancer types in Parkinson's disease (PD) patients and some PD genes are involved in cancer networks. OBJECTIVE The aim of this study is to assess the influence of several factors in the risk of cancer in a cohort of 753 PD patients and to study how these variables interact with each other. METHODS We analyzed the effect of gender, tobacco, alcohol, type of PD (genetic or idiopathic PD), and two genetic variants, previously associated with cancer, rs5848-GRN and rs1042522-TP53. RESULTS A higher age at PD onset was observed in patients who develop cancer before PD (p < 0.001). Alcohol consumption was a risk factor to develop cancer in PD patients (p = 0.011), while smoking was not a cancer risk factor in our cohort (p = 0.098). Among the genetic factors, the genotype TT GRN-rs5848 was statistically more frequent in PD patients without cancer (p = 0.05). CONCLUSIONS Our study identified several factors, genetic and nongenetic, which contribute to the risk for cancer in PD.
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Affiliation(s)
- Irene Rosas
- Laboratorio de Genética, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Germán Morís
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Eliecer Coto
- Laboratorio de Genética, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Marta Blázquez
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Esther Suárez
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Ciara García-Fernández
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Pablo Siso
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Carmen Martínez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Servicio de Neurología, Hospital Universitario de Cabueñes, Gijón, Spain
| | | | - Victoria Álvarez
- Laboratorio de Genética, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Manuel Menéndez-González
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
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Sanchez-Bayona R, Gardeazabal I, Romanos-Nanclares A, Fernandez-Lazaro CI, Alvarez-Alvarez I, Ruiz-Canela M, Gea A, Martinez-Gonzalez MA, Santisteban M, Toledo E. Leisure-time physical activity, sedentary behavior, and risk of breast cancer: Results from the SUN ('Seguimiento Universidad De Navarra') project. Prev Med 2021; 148:106535. [PMID: 33798533 DOI: 10.1016/j.ypmed.2021.106535] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 02/01/2021] [Accepted: 03/28/2021] [Indexed: 12/20/2022]
Abstract
Evidence is still limited on the influence of sedentary lifestyles on breast cancer (BC) risk. Also, prospective information on the combined effects of both sedentariness and leisure-time physical activity (LTPA) is scarce. We aimed to assess the association of higher sedentary behavior and LTPA (separately and in combination) with the risk of BC in a middle-aged cohort of university graduates. The SUN Project is a follow-up study initiated in 1999 with recruitment permanently open. Baseline assessments included a validated questionnaire on LTPA and sedentary habits. Subsequently, participants completed biennial follow-up questionnaires. Multivariable adjusted Cox models were used to estimate the hazard ratios (HR) for incident BC according to LTPA, TV-watching, the joint classification of both, and a combined 8-item multidimensional active lifestyle score. We included 10,812 women, with 11.8 years of median follow-up of. Among 115,802 women-years of follow-up, we confirmed 101 incident cases of BC. Women in the highest category of LTPA (>16.5 MET-h/week) showed a significantly lower risk of BC (HR = 0.55; 95% CI: 0.34-0.90) compared to women in the lowest category (≤6 MET/h-week). Women watching >2 h/d of TV sh owed a higher risk (HR = 1.67; 95% CI:1.03-2.72) than those who watched TV <1 h/d. Women in the highest category (6-8 points) of the multidimensional combined 8-item score showed a lower BC risk (HR = 0.35; 95% CI: 0.15-0.79) than those in the lowest category (<2 points) group. There was no significant supra-multiplicative interaction between TV-watching and LTPA. Both low LTPA and TV-watching >2 h/d may substantially increase BC risk, independently of each other.
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Affiliation(s)
- R Sanchez-Bayona
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Department of Clinical Oncology, Breast Cancer Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Department of Clinical Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - I Gardeazabal
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Department of Clinical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - A Romanos-Nanclares
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - C I Fernandez-Lazaro
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - I Alvarez-Alvarez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
| | - M Ruiz-Canela
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain
| | - A Gea
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain
| | - M A Martinez-Gonzalez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, USA
| | - M Santisteban
- Department of Clinical Oncology, Clínica Universidad de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - E Toledo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain.
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Reyna Villasmil E, Mejia-Montilla J, Reyna-Villasmil N, Torres-Cepeda D, Fernández-Ramírez A. Radioterapia y 5-fluorouracilo-cisplatino en el tratamiento del cáncer de cuello uterino de alto riesgo. REPERTORIO DE MEDICINA Y CIRUGÍA 2021. [DOI: 10.31260/repertmedcir.01217372.1040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo: evaluar la eficacia de la combinación de radioterapia y 5-fluorouracilo-cisplatino en el tratamiento del cáncer de cuello uterino de alto riesgo. Materiales y métodos: estudio retrospectivo en el que se revisaron los datos de pacientes tratadas en el periodo enero 2009 a diciembre 2019 en el Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Se revisaron los registros clínicos de todas las pacientes sometidas a histerectomía radical y linfadenectomía pélvica bilateral que recibieron quimio-radioterapia concurrente adyuvante con 5-fluorouracilo-cisplatino (grupo de tratamiento) y se compararon con quienes no fueron manejadas con este régimen, las que no recibieron ningún tratamiento adyuvante o solo fueron tratadas con radioterapia (grupo control). Se evaluaron las características generales, efectos adversos del tratamiento, recurrencias de la enfermedad y supervivencia. Resultados: para el análisis final quedaron 164 pacientes, de las cuales 115 (70,1%) fueron del grupo de tratamiento y 49 (29,9%) del control. No se encontraron diferencias estadísticamente significativas en las características clínicas entre ambos grupos (p = ns); sí las hubo en la frecuencia de recurrencias a distancia (p = 0,0056). La supervivencia libre de progresión y la global de ambos grupos no mostraron diferencias significativas (p = 0,2678 y p = 0,3452). Conclusión: no existen beneficios evidentes del uso de 5-fluorouracilo-cisplatino desde el punto de vista de progresión o supervivencia general, en pacientes con carcinoma cuello uterino de alto riesgo.
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Moyano A, Serrano-Pertierra E, Duque JM, Ramos V, Teruel-Barandiarán E, Fernández-Sánchez MT, Salvador M, Martínez-García JC, Sánchez L, García-Flórez L, Rivas M, Blanco-López MDC. Magnetic Lateral Flow Immunoassay for Small Extracellular Vesicles Quantification: Application to Colorectal Cancer Biomarker Detection. SENSORS 2021; 21:s21113756. [PMID: 34071520 PMCID: PMC8199047 DOI: 10.3390/s21113756] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 01/29/2023]
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer death and the fourth most common cancer in the world. Colonoscopy is the most sensitive test used for detection of CRC; however, their procedure is invasive and expensive for population mass screening. Currently, the fecal occult blood test has been widely used as a screening tool for CRC but displays low specificity. The lack of rapid and simple methods for mass screening makes the early diagnosis and therapy monitoring difficult. Extracellular vesicles (EVs) have emerged as a novel source of biomarkers due to their contents in proteins and miRNAs. Their detection would not require invasive techniques and could be considered as a liquid biopsy. Specifically, it has been demonstrated that the amount of CD147 expressed in circulating EVs is significant higher for CRC cell lines than for normal colon fibroblast cell lines. Moreover, CD147-containing EVs have been used as a biomarker to monitor response to therapy in patients with CRC. Therefore, this antigen could be used as a non-invasive biomarker for the detection and monitoring of CRC in combination with a Point-of-Care platform as, for example, Lateral Flow Immunoassays (LFIAs). Here, we propose the development of a quantitative lateral flow immunoassay test based on the use of magnetic nanoparticles as labels coupled to inductive sensor for the non-invasive detection of CRC by CD147-positive EVs. The results obtained for quantification of CD147 antigen embedded in EVs isolated from plasma sample have demonstrated that this device could be used as a Point-of-Care tool for CRC screening or therapy monitoring thanks to its rapid response and easy operation.
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Affiliation(s)
- Amanda Moyano
- Department of Physical and Analytical Chemistry & Institute of Biotechnology of Asturias, University of Oviedo, c/Julián Clavería 8, 33006 Oviedo, Spain; (A.M.); (E.S.-P.); (E.T.-B.)
| | - Esther Serrano-Pertierra
- Department of Physical and Analytical Chemistry & Institute of Biotechnology of Asturias, University of Oviedo, c/Julián Clavería 8, 33006 Oviedo, Spain; (A.M.); (E.S.-P.); (E.T.-B.)
| | - José María Duque
- Hospital Universitario San Agustín, 33401 Avilés, Spain; (J.M.D.); (V.R.); (L.S.)
- Department of Medicine, University of Oviedo, 33006 Oviedo, Spain
| | - Virginia Ramos
- Hospital Universitario San Agustín, 33401 Avilés, Spain; (J.M.D.); (V.R.); (L.S.)
| | - Estefanía Teruel-Barandiarán
- Department of Physical and Analytical Chemistry & Institute of Biotechnology of Asturias, University of Oviedo, c/Julián Clavería 8, 33006 Oviedo, Spain; (A.M.); (E.S.-P.); (E.T.-B.)
| | - María Teresa Fernández-Sánchez
- Department of Biochemistry and Molecular Biology & Institute of Biotechnology of Asturias, University of Oviedo, 33006 Oviedo, Spain;
| | - María Salvador
- Department of Physics & IUTA, University of Oviedo, Campus de Viesques, 33204 Gijón, Spain; (M.S.); (J.C.M.-G.); (M.R.)
| | - José Carlos Martínez-García
- Department of Physics & IUTA, University of Oviedo, Campus de Viesques, 33204 Gijón, Spain; (M.S.); (J.C.M.-G.); (M.R.)
| | - Luis Sánchez
- Hospital Universitario San Agustín, 33401 Avilés, Spain; (J.M.D.); (V.R.); (L.S.)
| | - Luis García-Flórez
- Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain;
- Department of Surgery and medical-surgical specialties, University of Oviedo, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Montserrat Rivas
- Department of Physics & IUTA, University of Oviedo, Campus de Viesques, 33204 Gijón, Spain; (M.S.); (J.C.M.-G.); (M.R.)
| | - María del Carmen Blanco-López
- Department of Physical and Analytical Chemistry & Institute of Biotechnology of Asturias, University of Oviedo, c/Julián Clavería 8, 33006 Oviedo, Spain; (A.M.); (E.S.-P.); (E.T.-B.)
- Correspondence:
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Uhry Z, Chatignoux E, Dantony E, Colonna M, Roche L, Fauvernier M, Defossez G, Leguyader-Peyrou S, Monnereau A, Grosclaude P, Bossard N, Remontet L. Multidimensional penalized splines for incidence and mortality-trend analyses and validation of national cancer-incidence estimates. Int J Epidemiol 2021; 49:1294-1306. [PMID: 32830255 DOI: 10.1093/ije/dyaa078] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Cancer-incidence and mortality-trend analyses require appropriate statistical modelling. In countries without a nationwide cancer registry, an additional issue is estimating national incidence from local-registry data. The objectives of this study were to (i) promote the use of multidimensional penalized splines (MPS) for trend analyses; (ii) estimate the national cancer-incidence trends, using MPS, from only local-registry data; and (iii) propose a validation process of these estimates. METHODS We used an MPS model of age and year for trend analyses in France over 1990-2015 with a projection up to 2018. Validation was performed for 22 cancer sites and relied essentially on comparison with reference estimates that used the incidence/health-care ratio over the period 2011-2015. Alternative estimates that used the incidence/mortality ratio were also used to validate the trends. RESULTS In the validation assessment, the relative differences of the incidence estimates (2011-2015) with the reference estimates were <5% except for testis cancer in men and < 7% except for larynx cancer in women. Trends could be correctly derived since 1990 despite incomplete histories in some registries. The proposed method was applied to estimate the incidence and mortality trends of female lung cancer and prostate cancer in France. CONCLUSIONS The validation process confirmed the validity of the national French estimates; it may be applied in other countries to help in choosing the most appropriate national estimation method according to country-specific contexts. MPS form a powerful statistical tool for trend analyses; they allow trends to vary smoothly with age and are suitable for modelling simple as well as complex trends thanks to penalization. Detailed trend analyses of lung and prostate cancers illustrated the suitability of MPS and the epidemiological interest of such analyses.
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Affiliation(s)
- Zoé Uhry
- Direction des Maladies Non Transmissibles et des Traumatismes, Santé Publique France, Saint-Maurice, France.,Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Edouard Chatignoux
- Direction des Maladies Non Transmissibles et des Traumatismes, Santé Publique France, Saint-Maurice, France
| | - Emmanuelle Dantony
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - Marc Colonna
- Registre des cancers de l'Isère, Grenoble, France
| | - Laurent Roche
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - Mathieu Fauvernier
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | | | | | - Alain Monnereau
- Registre des hémopathies malignes de la Gironde, Institut Bergonié, Bordeaux, France
| | - Pascale Grosclaude
- Registre des cancers du Tarn Cancer, Institut Claudius Regaud, Institut universitaire du cancer de Toulouse Oncopole (IUCT-O), Toulouse, France.,Laboratoire d'Epidémiologie et Analyses en Santé Publique (LEASP), UMR 1027, Inserm; Université Toulouse III, Toulouse, France
| | - Nadine Bossard
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - Laurent Remontet
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
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Gómez-Salgado J, Fagundo-Rivera J, Ortega-Moreno M, Allande-Cussó R, Ayuso-Murillo D, Ruiz-Frutos C. Night Work and Breast Cancer Risk in Nurses: Multifactorial Risk Analysis. Cancers (Basel) 2021; 13:1470. [PMID: 33806956 PMCID: PMC8004617 DOI: 10.3390/cancers13061470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 02/07/2023] Open
Abstract
Night work has been highlighted by the International Agency for Research on Cancer (IARC) as a likely carcinogenic factor for humans, associated with breast cancer and professions that require continuity of work. Knowing the impact that short and long-term night work has on the nurses' collective seems a priority, therefore, this study aims to analyse the relationship between night work and the development of breast cancer risk factors in nurses. For this, a cross-sectional study through an online questionnaire on breast cancer risk variables and working life was designed. The study was conducted in Spain and the sample consisted of 966 nurses, of whom 502 were healthy participants and 56 were breast cancer patients. These two groups were compared in the analyses. A descriptive analysis was performed, and the relationship was tested using χ2 independence test and OR calculation. The CHAID (Chi Square Automatic Interaction Detection) data mining method allowed for the creation of a segmentation tree for the main risk variables. The most significant risk variables related to working life have been the number of years worked, nights worked throughout life, and years working more than 3 nights per month. Exceeding 16 years of work has been significant for women and men. When the time worked is less than 16 years, the number of cases increases if there is a family history of cancer and if there have been more than 500 nights of work. High-intensity night work seems more harmful at an early age. The accumulation of years and nights worked increase the risk of breast cancer when factors such as sleep disturbance, physical stress, or family responsibilities come together.
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Affiliation(s)
- Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain;
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
| | - Javier Fagundo-Rivera
- Health Sciences Doctorate School, University of Huelva, 21071 Huelva, Spain;
- Centro Universitario de Enfermería Cruz Roja, University of Seville, 41009 Seville, Spain
- Escola Superior de Saúde, Universidade Atlântica, 2730-036 Barcarena, Portugal
| | - Mónica Ortega-Moreno
- Department of Economy, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain;
| | | | | | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain;
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
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Redondo-Sánchez D, Rodríguez-Barranco M, Ameijide A, Alonso FJ, Fernández-Navarro P, Jiménez-Moleón JJ, Sánchez MJ. Cancer incidence estimation from mortality data: a validation study within a population-based cancer registry. Popul Health Metr 2021; 19:18. [PMID: 33757540 PMCID: PMC7988947 DOI: 10.1186/s12963-021-00248-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 03/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Population-based cancer registries are required to calculate cancer incidence in a geographical area, and several methods have been developed to obtain estimations of cancer incidence in areas not covered by a cancer registry. However, an extended analysis of those methods in order to confirm their validity is still needed. Methods We assessed the validity of one of the most frequently used methods to estimate cancer incidence, on the basis of cancer mortality data and the incidence-to-mortality ratio (IMR), the IMR method. Using the previous 15-year cancer mortality time series, we derived the expected yearly number of cancer cases in the period 2004–2013 for six cancer sites for each sex. Generalized linear mixed models, including a polynomial function for the year of death and smoothing splines for age, were adjusted. Models were fitted under a Bayesian framework based on Markov chain Monte Carlo methods. The IMR method was applied to five scenarios reflecting different assumptions regarding the behavior of the IMR. We compared incident cases estimated with the IMR method to observed cases diagnosed in 2004–2013 in Granada. A goodness-of-fit (GOF) indicator was formulated to determine the best estimation scenario. Results A total of 39,848 cancer incidence cases and 43,884 deaths due to cancer were included. The relative differences between the observed and predicted numbers of cancer cases were less than 10% for most cancer sites. The constant assumption for the IMR trend provided the best GOF for colon, rectal, lung, bladder, and stomach cancers in men and colon, rectum, breast, and corpus uteri in women. The linear assumption was better for lung and ovarian cancers in women and prostate cancer in men. In the best scenario, the mean absolute percentage error was 6% in men and 4% in women for overall cancer. Female breast cancer and prostate cancer obtained the worst GOF results in all scenarios. Conclusion A comparison with a historical time series of real data in a population-based cancer registry indicated that the IMR method is a valid tool for the estimation of cancer incidence. The goodness-of-fit indicator proposed can help select the best assumption for the IMR based on a statistical argument. Supplementary Information The online version contains supplementary material available at 10.1186/s12963-021-00248-1.
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Affiliation(s)
- Daniel Redondo-Sánchez
- Granada Cancer Registry, Andalusian School of Public Health (EASP), Campus Universitario de Cartuja, C/Cuesta del Observatorio 4, 18011, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), University of Granada, Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Miguel Rodríguez-Barranco
- Granada Cancer Registry, Andalusian School of Public Health (EASP), Campus Universitario de Cartuja, C/Cuesta del Observatorio 4, 18011, Granada, Spain. .,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), University of Granada, Granada, Spain. .,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Alberto Ameijide
- Tarragona Cancer Registry, Foundation Society for Cancer Research and Prevention (FUNCA), Pere Virgili Health Research Institute (IISPV), Reus, Spain
| | | | - Pablo Fernández-Navarro
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Jose Juan Jiménez-Moleón
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), University of Granada, Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - María-José Sánchez
- Granada Cancer Registry, Andalusian School of Public Health (EASP), Campus Universitario de Cartuja, C/Cuesta del Observatorio 4, 18011, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), University of Granada, Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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Pineño-Flores C, Ambrona-Zafra D, Rodríguez-Pino JC, Soldevila-Verdeguer C, Palma-Zamora E, Molina-Romero FX, Morón-Canis JM, González-Argente FX, Morales-Soriano R. Cephalic pancreaticoduodenectomy for ductal adenocarcinoma in the elderly. Can we do it safely? Cir Esp 2021; 100:S0009-739X(21)00029-4. [PMID: 33714556 DOI: 10.1016/j.ciresp.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 01/03/2021] [Accepted: 01/17/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Surgery and chemotherapy have increased the survival of pancreatic cancer. The decrease in postoperative morbidity and mortality and increase in life expectancy, has expanded the indications por cephalic pancreaticoduodenectomy (PDC), although it remains controversial in the geriatric population. METHODS Retrospective study on a prospective database of patients with ductal adenocarcinoma of pancreas who underwent PDC between 2007-2018.The main objective was to analyse the morbidity-mortality and survival associated with PDC in patients≥75 years (elderly). RESULTS 79 patients were included, 21 of them older than 75 years (27%); within this group, 23.9% were over 80 years old. The ASA of both groups was similar. Patients≥75 years required more transfusions. No differences in operating time were observed, although more vascular resection were performed in the elderly (26 vs. 8.7%; P=.037). Morbidity was higher in the elderly (61.9 vs. 46.6%), although without differences. Patients aged≥75 years had more non-surgical complications (33.3%, P=.050), being pneumonia the most frequent. Postoperative mortality was higher in the≥75 years (9 vs. 0%; P=.017). The overall survival and disease-free survival did not show significant differences in both groups. CONCLUSIONS Elderly patients had higher postoperative mortality and more non-surgical complications. Survival did not show differences, so with an adequate selection of patients, age should not be considered itself as a contraindication for PDC.
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Affiliation(s)
- Cristina Pineño-Flores
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Baleares, España; Instituto de Investigación Sanitaria de Islas Baleares (IdISBa), Hospital Universitari Arnau de Villanova, Palma de Mallorca, Baleares, España.
| | - David Ambrona-Zafra
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Arnau de Vilanova, Lleida, Cataluña, España
| | - Jose Carlos Rodríguez-Pino
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Baleares, España
| | - Carla Soldevila-Verdeguer
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Baleares, España; Instituto de Investigación Sanitaria de Islas Baleares (IdISBa), Hospital Universitari Arnau de Villanova, Palma de Mallorca, Baleares, España
| | - Elias Palma-Zamora
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Baleares, España
| | - Francesc Xavier Molina-Romero
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Baleares, España; Instituto de Investigación Sanitaria de Islas Baleares (IdISBa), Hospital Universitari Arnau de Villanova, Palma de Mallorca, Baleares, España; Facultad de Medicina, Universidad de las Islas Baleares, Palma de Mallorca, Baleares, España
| | - Jose Miguel Morón-Canis
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Baleares, España
| | - Francesc Xavier González-Argente
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Baleares, España; Instituto de Investigación Sanitaria de Islas Baleares (IdISBa), Hospital Universitari Arnau de Villanova, Palma de Mallorca, Baleares, España; Facultad de Medicina, Universidad de las Islas Baleares, Palma de Mallorca, Baleares, España
| | - Rafael Morales-Soriano
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Baleares, España; Instituto de Investigación Sanitaria de Islas Baleares (IdISBa), Hospital Universitari Arnau de Villanova, Palma de Mallorca, Baleares, España
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Luque-Fernández MÁ, Redondo-Sánchez D, Fernández P, Salamanca-Fernández E, Marcos-Gragera R, Guevara M, Carulla Aresté M, Jiménez R, Núñez O, Sabater C, López de Munain Marqués A, Chirlaque MD, Mateos A, Rodríguez-Barranco M, Espín Balbino J, Pollán M, Sánchez MJ. [Study protocol on Socioeconomic and Geographic Inequalities in Cancer Incidence, Mortality and Survival in Spain: Multilevel Population-Base Study: DESOCANES study]. GACETA SANITARIA 2021; 35:199-203. [PMID: 32674866 DOI: 10.1016/j.gaceta.2020.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 11/30/2022]
Abstract
Incidence and mortality provide information on the burden of cancer morbidity and the potential years of life lost due to cancer. The Spanish Deprivation Index (SDI) has been developed as a standardized measure to study socioeconomic deprivation in Spain at the census tract level. In addition, SDI information can be combined with ecological variables at the population level and data from the High-Resolution European Studies in Cancer. The aim of this study is to characterize socioeconomic inequalities in incidence, excess mortality, premature mortality and net survival for three of the most incident cancers (lung, colon-rectum and breast) in Spain using the SDI. This national population-based study will assess the impact of socioeconomic inequalities using a multilevel modelling approach. Spatial analysis, multilevel modeling, net survival and economic impact assessment will be used. The results will be useful for supporting decision-making, planning, and management of public health interventions aimed at reducing the impact of socioeconomic inequalities in the diagnosis and prognosis of cancer patients in Spain.
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Affiliation(s)
- Miguel Ángel Luque-Fernández
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Daniel Redondo-Sánchez
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Escuela Andaluza de Salud Pública, Granada, España.
| | - Pablo Fernández
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
| | - Elena Salamanca-Fernández
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, España; Escuela Andaluza de Salud Pública, Granada, España
| | - Rafael Marcos-Gragera
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Unitat d'Epidemiologia i Registre de Cáncer de Girona, Pla Director d'Oncologia, Departament de Salut, Generalitat de Catalunya, Institut Català de Oncologia, Girona, España; Instituto de Investigación Biomédica de Girona (IDIBGI), Grupo de Epidemiología. Descriptiva, Genética y Prevención del Cáncer, Girona, España
| | - Marcela Guevara
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Instituto de Salud Pública de Navarra, Pamplona, España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España
| | | | | | - Olivier Núñez
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
| | | | | | | | | | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Escuela Andaluza de Salud Pública, Granada, España
| | - Jaime Espín Balbino
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Escuela Andaluza de Salud Pública, Granada, España
| | - Marina Pollán
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
| | - María-José Sánchez
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Escuela Andaluza de Salud Pública, Granada, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, España
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The incidence of skin melanoma in Gran Canaria (Canary Islands, Spain) is lower than expected in Southern Europe despite high-risk environmental conditions: an island-wide cross-sectional study. Cancer Causes Control 2021; 32:525-535. [PMID: 33646461 DOI: 10.1007/s10552-021-01403-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/29/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Canary Islands are a leading European touristic destination. The ultraviolet index (UVI) in the region is the highest in Spain, and similar to indexes registered in Australia and New Zealand, which hold the highest incidence of skin melanoma worldwide. Yet according to cancer registry data, the incidence in the Canary Islands in the late 1990s was the lowest in Spain (among the lowest in Europe) and about six times lower than in New Zealand. PURPOSE To analyze the incidence rates of skin melanoma in Gran Canaria island between 2007 and 2018. METHODS The study was based in the two centres of the Canary Islands' Healthcare Service centralizing melanoma care in Gran Canaria. We analyzed crude and age-standardized (ASR) incidence rates of invasive cutaneous melanoma for the period 2007-2018 following the inclusion criteria of the International Agency for Research on Cancer (IARC). Clinical and histological characteristics of melanoma patients were assessed. RESULTS A total of 1058 patients were included. The incidence rates obtained matched the latest available Canary Islands' cancer registry data, confirming its reliability (ASR, Segi-Doll world standard population: 6.4 cases per 100,000 habitants for 2008-2012). The incidence was also below the latest IARC predictions for Southern Europe (GLOBOCAN 2018). Histological characteristics of patients were similar to other Southern European series. CONCLUSIONS The incidence of skin melanoma in Gran Canaria is unexpectedly low for a Southern European population exposed to such a high UVI. Further research in the Canary Islands could provide insight into a better understanding of melanoma pathogenesis.
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Aguilera-Buenosvinos I, Fernandez-Lazaro CI, Romanos-Nanclares A, Gea A, Sánchez-Bayona R, Martín-Moreno JM, Martínez-González MÁ, Toledo E. Dairy Consumption and Incidence of Breast Cancer in the 'Seguimiento Universidad de Navarra' (SUN) Project. Nutrients 2021; 13:nu13020687. [PMID: 33669972 PMCID: PMC7924827 DOI: 10.3390/nu13020687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 01/21/2023] Open
Abstract
Dairy products might influence breast cancer (BC) risk. However, evidence is inconsistent. We sought to examine the association between dairy product consumption-and their subtypes-and incident BC in a Mediterranean cohort. The SUN ("Seguimiento Universidad de Navarra") Project is a Spanish dynamic ongoing cohort of university graduates. Dairy product consumption was estimated through a previously validated 136-item food frequency questionnaire (FFQ). Incident BC was reported in biennial follow-up questionnaires and confirmed with revision of medical records and consultation of the National Death Index. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated with Cox regression models. Among 123,297 women-years of follow-up (10,930 women, median follow-up 12.1 years), we confirmed 119 incident BC cases. We found a nonlinear association between total dairy product consumption and BC incidence (pnonlinear = 0.048) and a significant inverse association for women with moderate total dairy product consumption (HRQ2vs.Q1 = 0.49 (95% CI 0.28-0.84); HRQ3vs.Q1 = 0.49 (95% CI 0.29-0.84) ptrend = 0.623) and with moderate low-fat dairy product consumption (HRQ2vs.Q1 = 0.58 (95% CI 0.35-0.97); HRQ3vs.Q1 = 0.55 (95% CI 0.32-0.92), ptrend = 0.136). In stratified analyses, we found a significant inverse association between intermediate low-fat dairy product consumption and premenopausal BC and between medium total dairy product consumption and postmenopausal BC. Thus, dairy products, especially low-fat dairy products, may be considered within overall prudent dietary patterns.
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Affiliation(s)
- Inmaculada Aguilera-Buenosvinos
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, 31008 Pamplona, Spain; (I.A.-B.); (C.I.F.-L.); (A.R.-N.); (A.G.); (M.Á.M.-G.)
| | - Cesar Ignacio Fernandez-Lazaro
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, 31008 Pamplona, Spain; (I.A.-B.); (C.I.F.-L.); (A.R.-N.); (A.G.); (M.Á.M.-G.)
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Andrea Romanos-Nanclares
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, 31008 Pamplona, Spain; (I.A.-B.); (C.I.F.-L.); (A.R.-N.); (A.G.); (M.Á.M.-G.)
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Alfredo Gea
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, 31008 Pamplona, Spain; (I.A.-B.); (C.I.F.-L.); (A.R.-N.); (A.G.); (M.Á.M.-G.)
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), 28029 Madrid, Spain
| | - Rodrigo Sánchez-Bayona
- Department of Clinical Oncology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
| | - Jose M. Martín-Moreno
- Department of Preventive Medicine and Public Health, Medical School & INCLIVA, University of Valencia, 46010 Valencia, Spain;
| | - Miguel Ángel Martínez-González
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, 31008 Pamplona, Spain; (I.A.-B.); (C.I.F.-L.); (A.R.-N.); (A.G.); (M.Á.M.-G.)
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), 28029 Madrid, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Estefanía Toledo
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, 31008 Pamplona, Spain; (I.A.-B.); (C.I.F.-L.); (A.R.-N.); (A.G.); (M.Á.M.-G.)
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-948425600 (ext. 806224)
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Consensus of the Spanish society of laboratory medicine and the Spanish society of medical oncology on the methodology and criteria for evaluation of circulating tumour markers in breast cancer. Clin Transl Oncol 2021; 23:1272-1280. [PMID: 33550504 PMCID: PMC8192375 DOI: 10.1007/s12094-020-02529-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022]
Abstract
The measurement of circulating tumour markers (TMs) for the diagnosis or monitoring of breast cancer has sometimes been considered of limited utility. In addition to the overinterpretation of irrelevant changes in marker levels, the characteristics of the patient, the disease or other pathologies that can modify them are often not considered in their evaluation. On the other hand, there are recent data on the relationship of TMs with molecular subtypes and on their prognostic value, the knowledge of which may improve their clinical utility. This consensus article arises from a collaboration between the Spanish Society of Laboratory Medicine (SEQCML) and the Spanish Society of Medical Oncology (SEOM). It aims to improve the use and interpretation of circulating TMs in breast cancer. The text summarizes the current knowledge and available evidence on the subject and proposes a series of recommendations mainly focussed on the indication, the frequency of testing and the factors that should be considered for correctly interpreting changes in the levels of TMs.
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Effectiveness of Complementary Therapies in Cancer Patients: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031017. [PMID: 33498883 PMCID: PMC7908482 DOI: 10.3390/ijerph18031017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 12/25/2022]
Abstract
According to the World Health Organization, cancer is the second leading cause of death in the world. In Spain, about a quarter of a million cases were diagnosed in 2017, and 81% of the Spanish population has used, at least once, some kind of complementary therapy. Said therapies are increasingly being used by cancer patients. The purpose of the study is to analyse the effectiveness of complementary therapies among cancer patients. A systematic peer review was conducted following the PRISMA-ScR guide in four databases (PubMed, CINAHL, Scopus and WOS). The inclusion criteria were Randomised Clinical Trials, published between 2013 and 2018, with a value of 3 or more on the Jadad Scale. The protocol was registered in PROSPERO (CRD42019127593). The study sample amounted to 1845 patients (64.55% women), the most common being breast cancer patients (794), followed by lung cancer patients (341). Fifteen complementary therapies were identified. We found two studies for each of the following: electroacupuncture, phytotherapy, hypnotherapy, guided imagery and progressive muscle relaxation. From the remaining ones, we identified a study on each therapy. The findings reveal some effective complementary therapies: auriculotherapy and acupuncture, laser moxibustion, hypnosis, Ayurveda, electroacupuncture, progressive muscle relaxation and guided imagery, yoga, phytotherapy, music therapy and traditional Chinese medicine. On the other hand, electroacupuncture, laser moxibustion and traditional Chinese medicine presented adverse effects, and kinesiology did not show effectiveness.
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Trends of incidence, mortality and survival of multiple myeloma in Spain. A twenty-three-year population-based study. Clin Transl Oncol 2021; 23:1429-1439. [PMID: 33433836 DOI: 10.1007/s12094-020-02541-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/08/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Despite major advances, multiple myeloma remains an incurable disease. Epidemiological data from high-quality population-based registries are needed to understand the heterogeneous landscape of the disease. METHODS Incidence, mortality and survival in multiple myeloma were comprehensively analyzed in the Girona and Granada population-based cancer registries, over a 23-year study (1994-2016), divided into three periods (1994-2001, 2002-2009 and 2010-2016). Joinpoint regression analysis was used to estimate the annual percentage change in incidence and mortality. Age-standardized net survival was calculated with the Pohar-Perme method. RESULTS 1957 myeloma patients were included in the study, with a median age of 72 years. Age-standardized incidence and mortality rates decreased over time in both sexes and both rates were higher in males. Five-year age-standardized net survival by period was 27.4% (1994-2001), 38.8% (2002-2009), and 47.4% (2010-2016). Survival improved for all age groups: 32.4%, 74.1% and 78.5% for patients aged 15-49; 27.5%, 44.6%, and 58.5% for those aged 50-69; finally, 24.8%, 25.5%, and 26.3% for the older group. CONCLUSION Incidence remained overall stable throughout the study, with only a small increase for men. Mortality was progressively decreasing in both sexes. Both incidence and mortality were higher in men. Age plays a critical role in survival, with impressive improvement in patients younger than 70 years, but only a minor benefit in those older than 70.
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Tumoral volume measured preoperatively by magnetic resonance imaging is related to survival in endometrial cancer. Radiol Oncol 2021; 55:35-41. [PMID: 33885237 PMCID: PMC7877259 DOI: 10.2478/raon-2020-0064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 10/05/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The aim of the study was to determine if the endometrial tumor volume (TV) measured by magnetic resonance imaging (MRI-TV) is associated with survival in endometrial cancer and lymph nodes metastases (LN+). PATIENTS AND METHODS We evaluated the MRI imaging and records of 341 women with endometrial cancer and preoperative MRI from 2008 to 2018. The MRI-TV was calculated using the ellipsoid formula measuring three perpendicular tumor diameters. Tumor myometrial invasion was also analyzed. RESULTS Higher MRI-TV was associated with age ≥ 65y, non-endometrioid tumors, grade-3, deep-myometrial invasion, LN+ and advanced FIGO stage. There were 37 patients with LN+ (8.8%). Non-endometrioid tumors, deep-myometrial invasion, grade-3 and MRI-TV ≥ 10 cm3 were the factors associated with LN+. Using a receiver operating characteristic [ROC] curve, the MRI-TV cut-off for survival was 10 cm3 (area under curve [AUC] = 0.70; 95% CI: 0.61-0.73). 5 years disease-free (DFS) and overall survival (OS) was significantly lower in MRI-TV ≥ 10 cm3 (69.3% vs. 84.5%, and 75.4% vs. 96.1%, respectively). MRI-TV was considered an independent factor of DFS (HR: 2.20, 95% CI: 1.09-4.45, p = 0.029) and OS (HR: 3.88, 95% CI: 1.34-11.24, p = 0.012) in multivariate analysis. CONCLUSIONS MRI-TV was associated with LN+, and MRI-TV ≥ 10 cm3 was an independent prognostic factor of lower DFS and OS. The MRI-TV can be auxiliary information to plan the surgery strategy and predict the adjuvant treatment in women with endometrial cancer.
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Debesa-Tur G, Pérez-Brocal V, Ruiz-Ruiz S, Castillejo A, Latorre A, Soto JL, Moya A. Metagenomic analysis of formalin-fixed paraffin-embedded tumor and normal mucosa reveals differences in the microbiome of colorectal cancer patients. Sci Rep 2021; 11:391. [PMID: 33432015 PMCID: PMC7801721 DOI: 10.1038/s41598-020-79874-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023] Open
Abstract
An increased risk of developing colorectal cancer (CRC) and other types of tumor is associated to Lynch syndrome (LS), an inherited condition caused by germline mutations in mismatch repair genes. We selected a cohort of LS patients that had developed CRC and had undergone surgical resection. Formalin-fixed paraffin embedded (FFPE) tissue blocks from matched colorectal and normal mucosa were used for genomic DNA extraction with a commercial kit and sequenced by high-throughput sequencing. A metagenomic approach enabled the taxonomic and functional identification of the microbial community and associated genes detected in the specimens. Slightly lower taxonomic diversity was observed in the tumor compared to the non-tumor tissue. Furthermore, the most remarkable differences between tumors and healthy tissue was the significant increase in the genus Fusobacterium in the former, in particular the species F. nucleatum, as well as Camplylobacter or Bacteroides fragilis, in accordance with previous studies of CRC. However, unlike prior studies, the present work is not based on directed detection by qPCR but instead uses a metagenomic approach to retrieve the whole bacterial community, and addresses the additional difficulty of using long-term stored FFPE samples.
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Affiliation(s)
- Gabriela Debesa-Tur
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Área de Genómica y Salud, Valencia, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Vicente Pérez-Brocal
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Área de Genómica y Salud, Valencia, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Susana Ruiz-Ruiz
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Área de Genómica y Salud, Valencia, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Adela Castillejo
- Unidad de Genética Molecular, Hospital General Universitario de Elche, Alicante, Spain
- Departamento de Salud Elche, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Elche, Spain
| | - Amparo Latorre
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Área de Genómica y Salud, Valencia, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Biología Integrativa de Sistemas (I2Sysbio), Universitat de València and Consejo Superior de Investigaciones Científicas (CSIC), Paterna, Valencia, Spain
| | - José Luis Soto
- Unidad de Genética Molecular, Hospital General Universitario de Elche, Alicante, Spain
- Departamento de Salud Elche, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Elche, Spain
| | - Andrés Moya
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Área de Genómica y Salud, Valencia, Spain.
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
- Instituto de Biología Integrativa de Sistemas (I2Sysbio), Universitat de València and Consejo Superior de Investigaciones Científicas (CSIC), Paterna, Valencia, Spain.
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Marzo-Castillejo M, Vela-Vallespín C, Bellas-Beceiro B, Bartolomé-Moreno C, Ginés-Díaz Y, Melús-Palazón E. [PAPPS Cancer Expert Group. Cancer Prevention Recommendations. 2020 PAPPS update]. Aten Primaria 2021; 52 Suppl 2:44-69. [PMID: 33388117 PMCID: PMC7801199 DOI: 10.1016/j.aprim.2020.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 02/07/2023] Open
Abstract
El cáncer es una de las principales causas de morbilidad y mortalidad. El consumo de tabaco, la dieta poco saludable, la inactividad física son algunos de los factores de riesgo que forman parte del estilo de vida y que han provocado un aumento del cáncer. En este artículo se actualizan las evidencias y recomendaciones de las estrategias de prevención para cada uno de los cánceres con mayor incidencia, con base en la disminución de los factores de riesgo (prevención primaria) y en el diagnóstico precoz del cáncer, a través del cribado y la detección temprana de los signos y síntomas, en población de riesgo medio y de riesgo elevado.
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Affiliation(s)
- Mercè Marzo-Castillejo
- Unitat de Suport a la Recerca Metropolitana Sud, IDIAP Jordi Gol, Direcció d'Atenció Primària Costa de Ponent, Institut Català de la Salut, Barcelona, España.
| | - Carmen Vela-Vallespín
- ABS del Riu Nord i Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet, Barcelona, España
| | - Begoña Bellas-Beceiro
- Unidad Docente de Atención Familiar y Comunitaria La Laguna-Tenerife Norte, Complejo Hospitalario Universitario de Canarias, Santa Cruz de Tenerife, España
| | - Cruz Bartolomé-Moreno
- Centro de Salud Parque Goya de Zaragoza y Unidad Docente de Atención Familiar y Comunitaria Sector Zaragoza I, Servicio Aragonés de Salud, Zaragoza, España
| | | | - Elena Melús-Palazón
- Centro de Salud Actur Oeste de Zaragoza y Unidad Docente de Atención Familiar y Comunitaria Sector Zaragoza I, Servicio Aragonés de Salud, Zaragoza, España
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Darbà J, Marsà A. Evaluation of productivity losses due to premature mortality from colorectal cancer. PLoS One 2020; 15:e0244375. [PMID: 33362274 PMCID: PMC7757866 DOI: 10.1371/journal.pone.0244375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 12/08/2020] [Indexed: 12/30/2022] Open
Abstract
Cancer is responsible annually for around 27% of all deaths in Spain, 15% of which are caused by colorectal cancer. This malignancy has increased its incidence considerably over the past years, which surely impacts global productivity losses. The evaluation of lost productivity due to premature mortality provides valuable information that guides healthcare policies into the establishment of prevention and screening programs. The purpose of this study was to assess the productivity losses from premature deaths due to colorectal cancer over a ten year period (2008–2017). The costs derived from premature mortality due to this highly prevalent cancer were estimated using data on mortality, age- and sex-specific reference salaries and unemployment rates in Spain via the human capital approach. Between 2008 and 2017, 15,103 persons died per year from colorectal cancer, representing almost 15% of all cancer-related deaths. Annually, 25,333 years of potential productive life were estimated to be lost on average, 14,992 in males and 10,341 in females. Productivity losses summed €510.8 million in in 2017, and the cancers of the colon and rectum accounted for 9.6% of cancer-related productivity losses in 2017 in Spain. Colorectal cancer has an important weight in terms of productivity losses within the Spanish population, consequently, prevention and early detection programmes should be promoted and implemented to achieve significant reductions in mortality and productivity losses.
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Affiliation(s)
- Josep Darbà
- Department of Economics, Universitat de Barcelona, Barcelona, Spain
- * E-mail:
| | - Alicia Marsà
- Department of Health Economics, BCN Health Economics & Outcomes Research S.L., Barcelona, Spain
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Budget Impact Analysis of the Introduction of Rituximab and Trastuzumab Intravenous Biosimilars to EU-5 Markets. BioDrugs 2020; 35:89-101. [PMID: 33368051 PMCID: PMC7803676 DOI: 10.1007/s40259-020-00461-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 12/14/2022]
Abstract
Background Biologic treatments impose a large financial burden on healthcare payers. Subcutaneous formulations of trastuzumab and rituximab offer administration cost savings relative to the intravenous products through reduced preparation and infusion times. However, intravenous biosimilars have the potential to offset administration costs through lower drug costs. Objective The objective was to develop a budget impact model (BIM) from a payer’s perspective for the EU-5 countries (UK, France, Germany, Spain, Italy) to demonstrate the economic impact of using intravenous trastuzumab and rituximab biosimilars. Methods An incidence-based BIM was developed to estimate the net budget impact utilising epidemiology data from the literature, market research data on the use of relevant treatments in all approved indications, and corresponding costs. The budget impact was estimated for 5 years following introduction of the biosimilars. Results Analysis using the base-case results indicated that adoption of the biosimilars trastuzumab and rituximab would result in net cost savings. At year 5, the net budget saving ranged from €4.05 million to 303.86 million for rituximab and from €19 million to 172 million for trastuzumab. The cost saving could potentially extend treatment to 291–15,671 more patients with rituximab and 622–3688 more patients with trastuzumab. Conclusion This budget impact analysis emphasised that increased use of intravenous rituximab and trastuzumab biosimilars may result in cost savings from the payer’s perspective across the EU-5 countries. Supplementary Information The online version contains supplementary material available at 10.1007/s40259-020-00461-8.
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