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Cayuela L, Font González R, Lendínez-Cano G, Medina-López R, Cayuela A. The influence of age, period, and cohort factors on the incidence of kidney cancer in Spain 1990-2019: Evidence from the global burden of disease study. Actas Urol Esp 2024:S2173-5786(24)00057-X. [PMID: 38599570 DOI: 10.1016/j.acuroe.2024.04.006] [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: 02/05/2024] [Accepted: 02/19/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE This study aimed to assess the influence of age, period, and cohort (A-P-C) factors on kidney cancer (KC) incidence trends in Spain from 1990 to 2019. METHODS Employing data from the Global Burden of Disease Study 2019, we employed joinpoint analysis to determine long-term patterns and A-P-C modelling to quantify net drift, local drift, longitudinal age curves, and rate ratios (RRs) of period and cohort effects. RESULTS Over the period 1990-2019, an estimated 142,811 cases of KC were diagnosed in Spain. A consistent upward trend in KC incidence was observed for both men and women, with the male-to-female ratio remaining stable at 2.6. Joinpoint analysis identified three distinct periods for men: An initial period (1990-1995) characterised by a significant increase in rates, a subsequent period (1995-2016) characterised by a slowdown in the rate of increase, and a final period (2016-2019) in which rates have plateaued. In women, 2 time periods were observed: an initial period (1990-2007) in which rates increased significantly, followed by a period of stabilization (2007-2019). Men born in the early-mid 20th century had a rising KC risk, peaking in the 1960s. Women's risk rose steadily, peaking in the late 1990s. CONCLUSION A-P-C analysis reveals steady KC incidence increase in both genders over three decades. This highlights the need for targeted public health policies and effective prevention strategies.
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Affiliation(s)
- L Cayuela
- Servicio de Medicina Interna, Hospital Severo Ochoa, Leganés, Spain
| | - R Font González
- Servicio de Medicina Interna, Hospital Severo Ochoa, Leganés, Spain
| | - G Lendínez-Cano
- Unidad de Nefrología y Urología, Unidad de Uro-oncología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - R Medina-López
- Unidad de Nefrología y Urología, Unidad de Uro-oncología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - A Cayuela
- Unidad de Salud Pública, Prevención y Promoción de la Salud, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain.
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Perea LME, Antunes JLF, Peres MA. Approaches to the problem of nonidentifiability in the age-period-cohort models in the analysis of cancer mortality: a scoping review. Eur J Cancer Prev 2022; 31:93-103. [PMID: 34723867 DOI: 10.1097/cej.0000000000000713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Aiming to detect age, period and cohort effects in cancer mortality, age-period-cohort models (APC) can be applied to distinguish these effects. The main difficulty with adjusting an APC model involving age, period and cohort factors is the linear relationship between them, leading to a condition known as the 'nonidentifiability problem'. Many methods have been developed by statisticians to solve it, but there is not a consensus. All these existing methods, with their advantages and disadvantages, create confusion when choosing which one of them should be implemented. In this context, the present scoping review intends not to show all methods developed to avoid the nonidentifiability problem on APC models but to show which of them are, in fact, applied in the literature, especially in the cancer mortality studies. A search strategy was made to identify evidence on MEDLINE (PubMed), Scopus, EMBASE, Science Direct and Web of Science. A total of 46 papers were analyzed. The main methods found were: Holford's method (n = 14; 30%), ntrinsic estimator (n = 10; 22%), Osmond & Gardner method n = 8; 17%), Carstensen (n = 6;13%), Bayesian approach (n = 6;13%) and others (n = 2; 5%). Even with their limitations, all methods have beneficial applications. However, the decision to use one or another method seemed to be more related to an observed geographic pattern.
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Affiliation(s)
| | | | - Marco A Peres
- Senior Principal Investigator, National Dental Research Institute Singapore, National Dental Centre Singapore; Director, Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
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Patterns of and hypotheses for infection-related cancers in a Chinese population with rapid economic development. Epidemiol Infect 2011; 140:1904-19. [PMID: 22142566 DOI: 10.1017/s0950268811002469] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
With economic development, non-communicable diseases replace infectious diseases as the leading cause of death; how such transition occurs for infectious diseases with long latency has rarely been considered. We took advantage of a Chinese population with rapid economic development in the mid-20th century to study changing patterns of infection-related cancers. We used sex-specific Poisson regression to estimate age, period and cohort effects on adult deaths 1976-2005 from eight infection-related cancers in Hong Kong. Cervical, head and neck, and oesophageal cancers, associated with sexually transmitted infections, decreased for the first birth cohorts with sexual debut in a more developed environment. Leukaemia and non-Hodgkin's lymphoma, associated with vertically transmitted infections, decreased for the first cohorts born into a more developed environment. Birth cohort patterns were unclear for nasopharyngeal, stomach and liver cancers. Mortality rates for cancers related to early infections may depend on population history, with delayed reductions for some infection-related cancers.
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Abstract
Mortality from childhood cancers has shown substantial declines in developed countries since 1960, with smaller favourable trends in South America. This study describes mortality trends in renal childhood cancer mortality in São Paulo state, Brazil, from 1980 to 2000. The age-standardised mortality rates among the boys decreased from 0.36 per 100,000 inhabitants in 1984 to 0.09 in 1992, whereas the observed corresponding decline among girls was from 0.43 per 100,000 inhabitants in 1981 to 0.07 in 1990. Statistically significant declining trends in mortality rates were observed for boys (adjusted r(2) = 0.51, P < 0.001) and also for girls (adjusted r(2) = 0.40, P = 0.002), achieving in this group a significant reduction in age-standardised mortality rates in the period (annual percentage change = -4.21). Consistent decrease in mortality rates from childhood renal cancer was noted at São Paulo state. In the absence of changes in incidence rates, this decline could be attributed to the improvement in treatment protocols and supportive measures.
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Vera López I, Gandarillas Grande A, Díez-Gañán L, Zorrilla Torras B. Mortalidad por cáncer en niños y adolescentes de la Comunidad de Madrid, 1977-2001. An Pediatr (Barc) 2005; 62:420-6. [PMID: 15871823 DOI: 10.1157/13074615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION In the last few decades mortality from cancer among children and adolescents has not decreased homogeneously in industrialized countries. The aim of this study was to determine the epidemiological pattern and temporal trend of mortality from cancer in individuals aged less than 20 years old living in the Autonomous Community of Madrid from 1977 to 2001. MATERIAL AND METHODS Data on deaths from cancer among children and adolescents were obtained from Spain's National Institute of Statistics and from the Mortality Registry of Madrid. Populations were obtained from official publications of the Institute of Statistics of Madrid. Variables analyzed were sex, 5-year age groups, 5-year death periods and underlying cause of death. The epidemiological pattern was studied and a Poisson's regression model was used to analyze cancer mortality trends in children and adolescents from 1977 to 2001. RESULTS Cancer mortality among children and adolescents decreased by 41 % from 1977 to 2001. The decrease in mortality differed according to sex (46 % in boys and 33 % in girls) and type of cancer (leukemias: 38 %, non-Hodgkin's lymphomas: 58 %, malignant brain tumors: 45 %, malignant bone tumors: 19 %, ill-defined malignant tumors: 78 %). Moreover, the annual decrease was much greater in the last 5 years (4. 7 %) than during the entire period (2. 2 %). CONCLUSIONS Cancer mortality among children and adolescents decreased between 1977 and 2001 and our results are similar to those observed in other European and North American regions. To improve knowledge of the epidemiology of cancer among children and adolescents in the Autonomous Community of Madrid, future assessments including mortality, incidence, and survival indicators are required.
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Affiliation(s)
- I Vera López
- Servicio de Epidemiología, Sección de Enfermedades No Transmisibles, Instituto de Salud Pública, Consejería de Sanidad y Consumo, Comunidad de Madrid, España.
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Gonzalez JR, Fernandez E, de Toledo JS, Galceran J, Peris M, Gispert R, Borràs JM. Trends in Childhood Cancer Incidence and Mortality in Catalonia, Spain, 1975–1998. Eur J Cancer Prev 2004; 13:47-51. [PMID: 15075788 DOI: 10.1097/00008469-200402000-00008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Childhood cancer mortality has sharply declined in most economically developed countries over the last years, whereas no substantial changes in the incidence have been observed. In Catalonia (Spain), childhood cancer mortality showed a considerable decline until 1992, but incidence trends have not been analysed in this population. To assess both recent incidence and mortality trends in this population, we analysed childhood (0-14 years) cancer data from the population-based Tarragona Cancer Registry and from the Mortality Registry of Catalonia (Spain) from 1980 to 1998. All cancer mortality decreased by -2.6% annually in boys (95% confidence interval, 95% CI -3.7, -1.6) and -3.7% in girls (95% CI -4.9, -2.5). Mortality due to leukaemia decreased annually -3.0% in boys (95% CI -4.7, -1.4) and -4.4% in girls (95% CI -6.3, -2.4). Mortality for brain tumours showed a reduction of -3.2% in boys (95% CI -5.5, -0.9) and of -4.4% in girls (95% CI -6.3, -2.4). No significant trend in incidence rates, either in boys or in girls, was observed (annual per cent of change for all cancers -0.5%, 95% CI -3.5, 2.7, in boys and 1.7%, 95% CI -1.9, 5.5, in girls). These results suggest an improvement in both childhood cancer diagnosis and treatment, which may explain current higher childhood cancer survival rates.
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Affiliation(s)
- J R Gonzalez
- Servei de Prevenció i Control del Càncer, Institut Català d'Oncologia, Avda. Gran Vía s/n, km. 2,7, L'Hospitalet de Llobregat 08907, Barcelona, Spain.
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Wilkinson JR, Feltbower RG, Lewis IJ, Parslow RC, McKinney PA. Survival from adolescent cancer in Yorkshire, UK. Eur J Cancer 2001; 37:903-11. [PMID: 11313179 DOI: 10.1016/s0959-8049(01)00012-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to investigate survival rates for adolescents with cancer and identify factors associated with differential long-term prognosis in Yorkshire, UK. A survival analysis of a population-based cohort of young adults aged 15-24 years, diagnosed with a malignancy in the former Yorkshire Regional Health Authority between 1985 and 1994 was carried out. The main outcome was death from all causes. Overall survival for the 1097 adolescents with a malignancy increased by 30% between 1985-1989 and 1990-1994 (P=0.004). This improvement was reflected in most subgroups of cancer. Large scale geographical differences in survival rates were observed across Yorkshire, with an increased risk of death in North Yorkshire and Humberside of 34% and 45%, respectively, compared with West Yorkshire. Small scale analyses showed reduced survival in areas of high population density, but no consistent trends were associated with socio-economic status. Improved survival from all cancers in young adults over the last decade is clearly seen. Reasons for differential survival by geographical area are unclear and warrant further investigation.
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Affiliation(s)
- J R Wilkinson
- Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, LS2 9PL, Leeds, UK
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Pollán Santamaría M, López-Abente Ortega G, Aragonés Sanz N, González Diego P, Navas Acién A. Incidencia y mortalidad por leucemias en España. Semergen 2001. [DOI: 10.1016/s1138-3593(01)73974-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ruiz-Tovar M, López-Abente G, Pollán M, Aragonés N, Ardanaz E, Moreo P, Moreno C, Vergara A. Brain cancer incidence in the provinces of Zaragoza and Navarre (Spain): effect of age, period and birth cohort. J Neurol Sci 1999; 164:93-9. [PMID: 10385055 DOI: 10.1016/s0022-510x(99)00048-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Several studies have detected increases in malignant brain tumour incidence and mortality rates particularly among the elderly. We analyzed time trends in malignant brain tumors incidence in Zaragoza over the period 1973-1990 and Navarre over the period 1973-1991, two Spanish provinces that have been collecting data through their respective Cancer Registries for the last 20 years, using Poisson regression analysis of age, period of diagnosis and cohort. In general, age-adjusted rates showed a steady rise in both registries, except in the case of females in Navarre, for whom a decrease in risk was observed for the last period, 1988-1991. This increase is a reflection of the rise in incidence experienced by the elderly, since the cohorts successively register rates that are stable over time, and even downward in the case of females in Navarre. The risk run by generations born circa 1920-1930 was the highest encountered. Rates were higher in Navarre in both sexes and for all but the last period in females, when rates on the two registers stood level. Increasingly generalised use of CT scanning and magnetic resonance in the 1980s in Spain, coupled with better and more effective health care access for the elderly, are factors that may well have some bearing on these findings.
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Affiliation(s)
- M Ruiz-Tovar
- Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
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Pollán M, López-Abente G, Aragonés N, Ruiz M. Malignant brain tumour mortality among children and adolescents: geographical distribution in Spain. J Neurol Sci 1999; 163:127-36. [PMID: 10371073 DOI: 10.1016/s0022-510x(99)00010-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Log-linear Poisson mixed models were used to study provincial malignant brain tumour (MBT) mortality among children and adolescents in Spain (1975-1992) in order to investigate the influence of specific socio-economic factors and to produce smoothed estimators of standardised mortality ratios (SMRs). Interdependence between geographical units was taken into account by including provinces as random effect terms nested with the corresponding Autonomous Region (Spain's administrative divisions). MBT mortality showed a positive association with three variables: non-cancer-related infant mortality; percentage of provincial land surface area devoted to agriculture; and industrial/construction activity. According to the final model, SMRs increased by 4% with every 10% rise in the area devoted to agriculture, with a 4% excess risk predicted for every increase in non-cancer-related infant mortality of 1 per 1000 person-years, and a 7% excess risk for contiguous categories of industrial/construction activity. By smoothing extreme values caused by random variability, the regression model yielded a reasonable estimation of SMRs. While infant mortality may be linked to the quality of medical care available, the relationship seen between MBT mortality and agricultural area accords with the excess risk reported for farmers' offspring. Finally, industrial activity might be regarded as a risk factor or as a marker of other conditions also associated with these tumours.
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Affiliation(s)
- M Pollán
- Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
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