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Rouhafzay A, Yousefi J. Geographical Disparities in Colorectal Cancer in Canada: A Review. Curr Oncol Rep 2024:10.1007/s11912-024-01574-x. [PMID: 39073526 DOI: 10.1007/s11912-024-01574-x] [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] [Accepted: 06/27/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE OF REVIEW Colorectal cancer (CRC) is a prominent contributor to cancer-related mortality in Canada. This review paper sheds light on the research conducted in Canada to scrutinize the influence of economicfactors. The review seeks to uncover notable disparities in Colorectal cancer incidence and mortality rate across diverse Canadian populations, including Indigenous communities, rural dwellers, and individuals with lower socioeconomic status (SES). RECENT FINDINGS Recent investigations reveal significant disparities in CRC incidence, mortality, and treatment outcomes among various demographic groups in Canada. Indigenous peoples, rural populations, and those with lower SES are particularly vulnerable to these disparities. Access to screening and specialized cancer care is notably limited for these marginalized populations, exacerbating existing health inequities. Furthermore, emerging evidence underscores the potential influence of dietary factors on CRC risk, highlighting the importance of tailored prevention and treatment strategies. The findings underscore the urgent need for targeted interventions aimed at enhancing access to CRC screening and specialized cancer care for disadvantaged populations in Canada. By addressing these disparities, more individuals can undergo timely screening and receive early-stage diagnoses, thereby improving prognosis and ultimately saving lives. However, to effectively bridge these gaps, further research is imperative to elucidate the underlying mechanisms driving these disparities and to identify and implement effective interventions.
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Affiliation(s)
- Asal Rouhafzay
- Shannon School of Business, Cape Breton University, Sydney, NS, Canada
| | - Jamileh Yousefi
- Shannon School of Business, Cape Breton University, Sydney, NS, Canada.
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada.
- Nova Scotia Health Authority, Halifax, NS, Canada.
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2
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Kypriotakis G, Kim S, Karam-Hage M, Robinson JD, Minnix JA, Blalock JA, Cui Y, Beneventi D, Kim B, Pan IW, Shih YCT, Cinciripini PM. Examining the Association between Abstinence from Smoking and Healthcare Costs among Patients with Cancer. Cancer Prev Res (Phila) 2024; 17:217-225. [PMID: 37940143 PMCID: PMC11097145 DOI: 10.1158/1940-6207.capr-23-0245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/26/2023] [Accepted: 11/03/2023] [Indexed: 11/10/2023]
Abstract
Continuous tobacco use in patients with cancer is linked to substantial healthcare costs due to increased risks and complications, whereas quitting smoking leads to improved treatment outcomes and cost reductions. Addressing the need for empirical evidence on the economic impact of smoking cessation, this study examined the association between smoking cessation and healthcare cost utilization among a sample of 930 patients with cancer treated at The University of Texas MD Anderson Cancer Center's Tobacco Research and Treatment Program (TRTP). Applying conditional quantile regression and propensity scores to address confounding, our findings revealed that abstinence achieved through the TRTP significantly reduced the median cost during a 3-month period post-quitting by $1,095 [β = -$1,095, P = 0.007, 95% confidence interval (CI), = (-$1,886 to -$304)]. Sensitivity analysis corroborated these conclusions, showing a pronounced cost reduction when outlier data were excluded. The long-term accrued cost savings from smoking cessation could potentially offset the cost of participation in the TRTP program, underscoring its cost effectiveness. An important implication of this study is that by reducing smoking rates, healthcare systems can more efficiently allocate resources, enhance patient health outcomes, and lessen the overall cancer burden. PREVENTION RELEVANCE This study emphasizes the dual impact of smoking cessation programs in patients with cancer: quitting smoking and reducing healthcare costs. It highlights the importance of integrating cessation programs into cancer prevention strategies, ensuring both individual health benefits and broader, system-wide economic efficiencies. See related Spotlight, p. 197.
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Affiliation(s)
- George Kypriotakis
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Seokhun Kim
- Center for Clinical Research and Evidence-Based Medicine, The University of Texas McGovern Medical School at Houston, Houston, TX
| | - Maher Karam-Hage
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jason D Robinson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jennifer A Minnix
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Janice A Blalock
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yong Cui
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Diane Beneventi
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - I-Wen Pan
- Department of Health Services Research The University of Texas MD Anderson Cancer Center, Houston, Texas (All work on this manuscript was conducted prior to Dr. Pan’s departure from The University of Texas MD Anderson Cancer Center.)
| | - Ya-Chen Tina Shih
- Program in Cancer Health Economics Research, UCLA Jonsson Cancer Center and School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Paul M Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Saint-Jacques N, Brown PE, Purcell J, Rainham DG, Terashima M, Dummer TJB. The Nova Scotia Community Cancer Matrix: A geospatial tool to support cancer prevention. Soc Sci Med 2023; 330:116038. [PMID: 37390806 DOI: 10.1016/j.socscimed.2023.116038] [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: 02/06/2023] [Revised: 05/26/2023] [Accepted: 06/16/2023] [Indexed: 07/02/2023]
Abstract
Globally, cancer is a leading cause of death and morbidity and its burden is increasing worldwide. It is established that medical approaches alone will not solve this cancer crisis. Moreover, while cancer treatment can be effective, it is costly and access to treatment and health care is vastly inequitable. However, almost 50% of cancers are caused by potentially avoidable risk factors and are thus preventable. Cancer prevention represents the most cost-effective, feasible and sustainable pathway towards global cancer control. While much is known about cancer risk factors, prevention programs often lack consideration of how place impacts cancer risk over time. Maximizing cancer prevention investment requires an understanding of the geographic context for why some people develop cancer while others do not. Data on how community and individual level risk factors interact is therefore required. The Nova Scotia Community Cancer Matrix (NS-Matrix) study was established in Nova Scotia (NS), a small province in Eastern Canada with a population of 1 million. The study integrates small-area profiles of cancer incidence with cancer risk factors and socioeconomic conditions, to inform locally relevant and equitable cancer prevention strategies. The NS-Matrix Study includes over 99,000 incident cancers diagnosed in NS between 2001 and 2017, georeferenced to small-area communities. In this analysis we used Bayesian inference to identify communities with high and low risk for lung and bladder cancer: two highly preventable cancers with rates in NS exceeding the Canadian average, and for which key risk factors are high. We report significant spatial heterogeneity in lung and bladder cancer risk. The identification of spatial disparities relating to a community's socioeconomic profile and other spatially varying factors, such as environmental exposures, can inform prevention. Adopting Bayesian spatial analysis methods and utilizing high quality cancer registry data provides a model to support geographically-focused cancer prevention efforts, tailored to local community needs.
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Affiliation(s)
- Nathalie Saint-Jacques
- NSH Cancer Care Program, Bethune Building, 1276 South Park St, Halifax, NS, Canada; Healthy Populations Institute, Dalhousie University, 1318 Robie St., Halifax, NS, Canada.
| | - Patrick E Brown
- Department of Statistical Science, University of Toronto, Sidney Smith Hall, 100 St. George Street, Toronto, ON, Canada.
| | - Judy Purcell
- NSH Cancer Care Program, Bethune Building, 1276 South Park St, Halifax, NS, Canada.
| | - Daniel G Rainham
- School of Health and Human Performance, Dalhousie University, 5981 University Avenue, Halifax, NS, Canada; Healthy Populations Institute, Dalhousie University, 1318 Robie St., Halifax, NS, Canada.
| | - Mikiko Terashima
- School of Planning, Dalhousie University, O'Brien Hall, 5217 Morris St., Halifax, NS, Canada.
| | - Trevor J B Dummer
- School of Population and Public Health, University of British Columbia, 226 East Mall, Vancouver, BC, Canada.
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Zawertailo L, Kabir T, Voci S, Tanzini E, Attwells S, Malat L, Veldhuizen S, Minian N, Dragonetti R, Melamed OC, Mei-Dan E, Selby P. Coordinating smoking cessation treatment with menstrual cycle phase to improve quit outcomes (MC-NRT): study protocol for a randomized controlled trial. Trials 2023; 24:251. [PMID: 37005655 PMCID: PMC10066995 DOI: 10.1186/s13063-023-07196-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/20/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Women experience greater difficulty achieving smoking abstinence compared to men. Recent evidence suggests that hormonal fluctuations during different phases of the menstrual cycle can contribute to lower smoking abstinence rates following a quit attempt among women. However, these findings are limited by small sample sizes and variability among targeted smoking quit dates. This clinical trial aims to clarify whether targeting the quit date to the follicular or luteal phase of the menstrual cycle can improve smoking abstinence. METHODS Participants will enroll in an online smoking cessation program providing nicotine replacement therapy (NRT) and behavioral support. We will randomize 1200 eligible individuals to set a target quit date: (1) during the mid-luteal phase, (2) during the mid-follicular phase, or (3) 15-30 days after enrollment with no regard to the menstrual cycle phase (usual practice). Participants will receive a 6-week supply of combination NRT consisting of a nicotine patch plus their choice of nicotine gum or lozenge. Participants will be instructed to start using NRT on their target quit date. Optional behavioral support will consist of a free downloadable app and brief videos focusing on building a quit plan, coping with cravings, and relapse prevention, delivered via e-mail. Smoking status will be assessed via dried blood spot analysis of cotinine concentration at 7 days, 6 weeks, and 6 months post-target quit date. DISCUSSION We aim to overcome the limitations of previous studies by recruiting a large sample of participants and assigning target quit dates to the middle of both the follicular and luteal phases. The results of the trial can further elucidate the effects of the menstrual cycle on smoking cessation outcomes and whether it is beneficial to combine menstrual cycle phase timing strategies with accessible and low-cost NRT. TRIAL REGISTRATION ClinicalTrials.gov NCT05515354. Registered on August 23, 2022.
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Affiliation(s)
- Laurie Zawertailo
- INTREPID Lab (formerly Nicotine Dependence Service), Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada.
- Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 100 Stokes St., Toronto, Ontario, M6J 1H4, Canada.
| | - Tina Kabir
- INTREPID Lab (formerly Nicotine Dependence Service), Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada
- Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Sabrina Voci
- INTREPID Lab (formerly Nicotine Dependence Service), Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada
| | - Elise Tanzini
- INTREPID Lab (formerly Nicotine Dependence Service), Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada
| | - Sophia Attwells
- INTREPID Lab (formerly Nicotine Dependence Service), Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada
| | - Liliana Malat
- INTREPID Lab (formerly Nicotine Dependence Service), Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada
| | - Scott Veldhuizen
- INTREPID Lab (formerly Nicotine Dependence Service), Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada
| | - Nadia Minian
- INTREPID Lab (formerly Nicotine Dependence Service), Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada
- Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 100 Stokes St., Toronto, Ontario, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario, M5T 1R8, Canada
- Department of Family and Community Medicine, University of Toronto, 500 University Ave., Toronto, Ontario, M5G 1V7, Canada
| | - Rosa Dragonetti
- INTREPID Lab (formerly Nicotine Dependence Service), Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada
- Department of Family and Community Medicine, University of Toronto, 500 University Ave., Toronto, Ontario, M5G 1V7, Canada
| | - Osnat C Melamed
- INTREPID Lab (formerly Nicotine Dependence Service), Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada
- Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Elad Mei-Dan
- North York General Hospital, 4001 Leslie St., Toronto, Ontario, M2K 1E1, Canada
| | - Peter Selby
- INTREPID Lab (formerly Nicotine Dependence Service), Centre for Addiction and Mental Health, 1025 Queen St. W, Toronto, Ontario, M6J 1H4, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 100 Stokes St., Toronto, Ontario, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario, M5T 1R8, Canada
- Department of Family and Community Medicine, University of Toronto, 500 University Ave., Toronto, Ontario, M5G 1V7, Canada
- Dalla Lana School of Public Health, 155 College St., Toronto, Ontario, M5T 3M7, Canada
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Laaksonen MA, Li S, Canfell K, MacInnis RJ, Giles GG, Banks E, Byles JE, Magliano DJ, Shaw JE, Gill TK, Hirani V, Cumming RG, Mitchell P, Bonello M, Vajdic CM. The future burden of oesophageal and stomach cancers attributable to modifiable behaviours in Australia: a pooled cohort study. Br J Cancer 2023; 128:1052-1069. [PMID: 36564563 PMCID: PMC10006078 DOI: 10.1038/s41416-022-02104-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND We quantified the individual and joint contribution of contemporaneous causal behavioural exposures on the future burden of oesophageal and stomach cancers and their subtypes and assessed whether these burdens differ between population groups in Australia, as such estimates are currently lacking. METHODS We combined hazard ratios from seven pooled Australian cohorts (N = 367,058) linked to national cancer and death registries with exposure prevalence from the 2017-2018 National Health Survey to estimate Population Attributable Fractions (PAFs) with 95% confidence intervals (CIs), accounting for competing risk of death. RESULTS Current and past smoking explain 35.2% (95% CI = 11.7-52.4%), current alcohol consumption exceeding three drinks/day 15.7% (95% CI = 0.9-28.4%), and these exposures jointly 41.4% (95% CI = 19.8-57.3%) of oesophageal squamous cell carcinomas in Australia. Current and past smoking contribute 38.2% (95% CI = 9.4-57.9%), obesity 27.0% (95% CI = 0.6-46.4%), and these exposures jointly 54.4% (95% CI = 25.3-72.1%) of oesophageal adenocarcinomas. Overweight and obesity explain 36.1% (95% CI = 9.1-55.1%), current and past smoking 24.2% (95% CI = 4.2-40.0%), and these exposures jointly 51.2% (95% CI = 26.3-67.8%) of stomach cardia cancers. Several population groups had a significantly higher smoking-attributable oesophageal cancer burden, including men and those consuming excessive alcohol. CONCLUSIONS Smoking is the leading preventable behavioural cause of oesophageal cancers and overweight/obesity of stomach cancers.
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Affiliation(s)
- Maarit A Laaksonen
- School of Mathematics and Statistics, University of New South Wales, Sydney, NSW, Australia.
| | - Siqi Li
- School of Mathematics and Statistics, University of New South Wales, Sydney, NSW, Australia
| | - Karen Canfell
- Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Sydney, NSW, Australia
| | - Robert J MacInnis
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Julie E Byles
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, NSW, Australia
| | - Dianna J Magliano
- Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Jonathan E Shaw
- Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Vasant Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Robert G Cumming
- School of Public Health, The University of Sydney, Sydney, NSW, Australia
- ANZAC Research Institute, The University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - Paul Mitchell
- Centre for Vision Research, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | | | - Claire M Vajdic
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Brobbey A, Rydz E, Fenton S, Demers PA, Ge CB, Peters CE. Characterizing occupational radon exposure greater than 100 Bq/m 3 in a highly exposed country. Sci Rep 2022; 12:21323. [PMID: 36494406 PMCID: PMC9734100 DOI: 10.1038/s41598-022-25547-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
Radon is an established lung carcinogen concentrating in indoor environments with importance for many workers worldwide. However, a systematic assessment of radon levels faced by all workers, not just those with direct uranium or radon exposure, has not previously been completed. The objective of this study was to estimate the prevalence of workers exposed to radon, and the level of exposure (> 100-200 Bq/m3, 200-400 Bq/m3, 400-800 Bq/m3, and > 800 Bq/m3) in a highly exposed country (Canada). Exposures among underground workers were assessed using the CAREX Canada approach. Radon concentrations in indoor workplaces, obtained from two Canadian surveys, were modelled using lognormal distributions. Distributions were then applied to the susceptible indoor worker population to yield the number of exposed workers, by occupation, industry, province, and sex. In total, an estimated 603,000 out of Canada's 18,268,120 workers are exposed to radon in Canada. An estimated52% of exposed workers are women, even though they comprise only 48% of the labour force. The majority (68%) are exposed at a level of > 100-200 Bq/m3. Workers are primarily exposed in educational services, professional, scientific and technical services, and health care and social assistance, but workers in mining, quarrying, and oil and gas extraction have the largest number of exposed workers at high levels (> 800 Bq/m3). Overall, a significant number of workers are exposed to radon, many of whom are not adequately protected by existing guidelines. Radon surveys across multiple industries and occupations are needed to better characterize occupational exposure. These results can be used to identify exposed workers, and to support lung cancer prevention programs within these groups.
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Affiliation(s)
- A. Brobbey
- grid.17091.3e0000 0001 2288 9830CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC Canada ,grid.22072.350000 0004 1936 7697Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - E. Rydz
- grid.17091.3e0000 0001 2288 9830CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC Canada ,grid.22072.350000 0004 1936 7697Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - S. Fenton
- grid.17091.3e0000 0001 2288 9830CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC Canada ,grid.22072.350000 0004 1936 7697Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - P. A. Demers
- grid.512212.7Occupational Cancer Research Centre, Ontario Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - C. B. Ge
- grid.4858.10000 0001 0208 7216TNO, The Hague, The Netherlands
| | - C. E. Peters
- grid.17091.3e0000 0001 2288 9830CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC Canada ,grid.22072.350000 0004 1936 7697Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB Canada ,grid.418246.d0000 0001 0352 641XBCCDC, Vancouver, BC Canada ,BC Cancer, Vancouver, BC Canada
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Hoch JS, Barr HK, Guggenbickler AM, Dewa CS. Lessons from Cost-Effectiveness Analysis of Smoking Cessation Programs for Cancer Patients. Curr Oncol 2022; 29:6982-6991. [PMID: 36290826 PMCID: PMC9600008 DOI: 10.3390/curroncol29100549] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Smoking among patients diagnosed with cancer poses important health and financial challenges including reduced effectiveness of expensive cancer therapies. This study explores the value of smoking cessation programs (SCPs) for patients already diagnosed with cancer. It also identifies conditions under which SPCs may be wise investments. METHODS Using a simplified decision analytic model combined with insights from a literature review, we explored the cost-effectiveness of SCPs. RESULTS The findings provide insights about the potential impact of cessation probabilities among cancer patients in SCPs and the potential impact of SCPs on cancer patients' lives. CONCLUSION The evidence suggests that there is good reason to believe that SCPs are an economically attractive way to improve outcomes for cancer patients when SCPs are offered in conjunction with standard cancer care.
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Affiliation(s)
- Jeffrey S. Hoch
- Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, CA 95616, USA
- Center for Healthcare Policy and Research, University of California, Sacramento, CA 95820, USA
- Correspondence:
| | - Heather K. Barr
- Graduate Group in Public Health Sciences, Department of Public Health Sciences, University of California, Davis, CA 95616, USA
| | - Andrea M. Guggenbickler
- Graduate Group in Public Health Sciences, Department of Public Health Sciences, University of California, Davis, CA 95616, USA
| | - Carolyn S. Dewa
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA 95616, USA
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Arifin H, Chou KR, Ibrahim K, Fitri SUR, Pradipta RO, Rias YA, Sitorus N, Wiratama BS, Setiawan A, Setyowati S, Kuswanto H, Mediarti D, Rosnani R, Sulistini R, Pahria T. Analysis of Modifiable, Non-Modifiable, and Physiological Risk Factors of Non-Communicable Diseases in Indonesia: Evidence from the 2018 Indonesian Basic Health Research. J Multidiscip Healthc 2022; 15:2203-2221. [PMID: 36213176 PMCID: PMC9532265 DOI: 10.2147/jmdh.s382191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/19/2022] [Indexed: 12/08/2022] Open
Affiliation(s)
- Hidayat Arifin
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, Republic of China
- Correspondence: Hidayat Arifin, Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang, KM. 21, Hegarmanah, Jatinangor, Sumedang, West Java, 45363, Indonesia, Tel +62 811 3194 433, Email
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Kusman Ibrahim
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
| | - Siti Ulfah Rifa’atul Fitri
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
| | - Rifky Octavia Pradipta
- Department of Fundamental Nursing Care, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Yohanes Andy Rias
- Department of Medical and Surgical Nursing, Institut Ilmu Kesehatan Bhakti Wiyata Kediri, Kediri, Indonesia
| | - Nikson Sitorus
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Jakarta, Indonesia
| | - Bayu Satria Wiratama
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Agus Setiawan
- Department of Community Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Setyowati Setyowati
- Department of Maternity Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Heri Kuswanto
- Department of Statistics, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia
| | - Devi Mediarti
- Politeknik Kesehatan Kemenkes Palembang, Palembang, Indonesia
| | - Rosnani Rosnani
- Politeknik Kesehatan Kemenkes Palembang, Palembang, Indonesia
| | | | - Tuti Pahria
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
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9
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Safiri S, Nejadghaderi SA, Abdollahi M, Carson‐Chahhoud K, Kaufman JS, Bragazzi NL, Moradi‐Lakeh M, Mansournia MA, Sullman MJM, Almasi‐Hashiani A, Taghizadieh A, Collins GS, Kolahi A. Global, regional, and national burden of cancers attributable to tobacco smoking in 204 countries and territories, 1990-2019. Cancer Med 2022; 11:2662-2678. [PMID: 35621231 PMCID: PMC9249976 DOI: 10.1002/cam4.4647] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/17/2022] [Accepted: 02/25/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Cancers are leading causes of mortality and morbidity, with smoking being recognized as a significant risk factor for many types of cancer. We aimed to report the cancer burden attributable to tobacco smoking by sex, age, socio-demographic index (SDI), and cancer type in 204 countries and territories from 1990 to 2019. METHODS The burden of cancers attributable to smoking was reported between 1990 and 2019, based upon the Comparative Risk Assessment approach used in the Global Burden of Disease (GBD) study 2019. RESULTS Globally, in 2019 there were an estimated 2.5 million cancer-related deaths (95% UI: 2.3 to 2.7) and 56.4 million DALYs (51.3 to 61.7) attributable to smoking. The global age-standardized death and DALY rates of cancers attributable to smoking per 100,000 decreased by 23.0% (-29.5 to -15.8) and 28.6% (-35.1 to -21.5), respectively, over the period 1990-2019. Central Europe (50.4 [44.4 to 57.6]) and Western Sub-Saharan Africa (6.7 [5.7 to 8.0]) had the highest and lowest age-standardized death rates, respectively, for cancers attributable to smoking. In 2019, the age-standardized DALY rate of cancers attributable to smoking was highest in Greenland (2224.0 [1804.5 to 2678.8]) and lowest in Ethiopia (72.2 [51.2 to 98.0]). Also in 2019, the global number of DALYs was highest in the 65-69 age group and there was a positive association between SDI and the age-standardized DALY rate. CONCLUSIONS The results of this study clearly illustrate that renewed efforts are required to increase utilization of evidence-based smoking cessation support in order to reduce the burden of smoking-related diseases.
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Affiliation(s)
- Saeid Safiri
- Aging Research InstituteTabriz University of Medical SciencesTabrizIran
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of MedicineTabriz University of Medical SciencesTabrizIran
| | - Seyed Aria Nejadghaderi
- Aging Research InstituteTabriz University of Medical SciencesTabrizIran
- Systematic Review and Meta‐analysis Expert Group (SRMEG)Universal Scientific Education and Research Network (USERN)TehranIran
| | - Morteza Abdollahi
- Social Determinants of Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Kristin Carson‐Chahhoud
- Australian Centre for Precision HealthUniversity of South AustraliaAdelaideSouth AustraliaAustralia
- School of MedicineUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Jay S. Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of MedicineMcGill UniversityQuebecCanada
| | | | - Maziar Moradi‐Lakeh
- Preventive Medicine and Public Health Research CenterIran University of Medical SciencesTehranIran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Mark J. M. Sullman
- Department of Life and Health SciencesUniversity of NicosiaNicosiaCyprus
- Department of Social SciencesUniversity of NicosiaNicosiaCyprus
| | - Amir Almasi‐Hashiani
- Department of Epidemiology, School of HealthArak University of Medical SciencesArakIran
| | - Ali Taghizadieh
- Tuberculosis and Lung Diseases Research CenterTabriz University of Medical SciencesTabrizIran
| | - Gary S. Collins
- Centre for Statistics in Medicine, NDORMS, Botnar Research CentreUniversity of OxfordOxfordUK
- NIHR Oxford Biomedical Research CentreOxford University Hospitals NHS Foundation TrustOxfordUK
| | - Ali‐Asghar Kolahi
- Social Determinants of Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
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10
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Brenner DR, Poirier A, Woods RR, Ellison LF, Billette JM, Demers AA, Zhang SX, Yao C, Finley C, Fitzgerald N, Saint-Jacques N, Shack L, Turner D, Holmes E. Projected estimates of cancer in Canada in 2022. CMAJ 2022; 194:E601-E607. [PMID: 35500919 PMCID: PMC9067380 DOI: 10.1503/cmaj.212097] [Citation(s) in RCA: 130] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Regular cancer surveillance is crucial for understanding where progress is being made and where more must be done. We sought to provide an overview of the expected burden of cancer in Canada in 2022. METHODS We obtained data on new cancer incidence from the National Cancer Incidence Reporting System (1984-1991) and Canadian Cancer Registry (1992-2018). Mortality data (1984-2019) were obtained from the Canadian Vital Statistics - Death Database. We projected cancer incidence and mortality counts and rates to 2022 for 22 cancer types by sex and province or territory. Rates were age standardized to the 2011 Canadian standard population. RESULTS An estimated 233 900 new cancer cases and 85 100 cancer deaths are expected in Canada in 2022. We expect the most commonly diagnosed cancers to be lung overall (30 000), breast in females (28 600) and prostate in males (24 600). We also expect lung cancer to be the leading cause of cancer death, accounting for 24.3% of all cancer deaths, followed by colorectal (11.0%), pancreatic (6.7%) and breast cancers (6.5%). Incidence and mortality rates are generally expected to be higher in the eastern provinces of Canada than the western provinces. INTERPRETATION Although overall cancer rates are declining, the number of cases and deaths continues to climb, owing to population growth and the aging population. The projected high burden of lung cancer indicates a need for increased tobacco control and improvements in early detection and treatment. Success in breast and colorectal cancer screening and treatment likely account for the continued decline in their burden. The limited progress in early detection and new treatments for pancreatic cancer explains why it is expected to be the third leading cause of cancer death in Canada.
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Affiliation(s)
- Darren R Brenner
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont.
| | - Abbey Poirier
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Ryan R Woods
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Larry F Ellison
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Jean-Michel Billette
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Alain A Demers
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Shary Xinyu Zhang
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Chunhe Yao
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Christian Finley
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Natalie Fitzgerald
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Nathalie Saint-Jacques
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Lorraine Shack
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Donna Turner
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
| | - Elizabeth Holmes
- Departments of Oncology and Community Health Sciences (Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Poirier), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Population Oncology (Woods), BC Cancer, Vancouver, BC; Centre for Population Health Data (Ellison, Billette, Zhang, Yao), Statistics Canada; Centre for Surveillance and Applied Research (Demers), Public Health Agency of Canada, Ottawa, Ont.; Departments of Surgery (Finley), McMaster University, St. Joseph's Health Care Centre, Hamilton, Ont.; Performance (Fitzgerald), Canadian Partnership Against Cancer, Toronto, Ont.; Nova Scotia Health Cancer Care Program (Saint-Jacques), Halifax, NS; Population Oncology (Shack), Cancer Care Manitoba, Winnipeg, Man.; Surveillance and Reporting (Turner), Cancer Care Alberta, Calgary, Alta.; Cancer Information and Policy Department (Holmes), Canadian Cancer Society, Toronto, Ont
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11
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Friedenreich CM, Yang L. Physical Activity to Improve Lung Cancer Survival: Promising Evidence. JNCI Cancer Spectr 2022; 6:pkac011. [PMID: 35603842 PMCID: PMC8962745 DOI: 10.1093/jncics/pkac011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Center, Calgary, Canada
- Department of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Center, Calgary, Canada
- Department of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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12
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Zhang Q, Zeng G, Wang X, Wu KH. Associations of exposure to secondhand smoke with hypertension risk and blood pressure values in adults. Environ Health Prev Med 2021; 26:86. [PMID: 34488622 PMCID: PMC8422707 DOI: 10.1186/s12199-021-01009-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/21/2021] [Indexed: 12/19/2022] Open
Abstract
Background The effects of environmental chemical exposure on blood pressure (BP) have been confirmed, but the association between exposure to secondhand smoke (SHS) and hypertension risk and BP in the general population remains unknown. Methods Cross-sectional associations between SHS exposure and hypertension risk and BP values were evaluated using data for subjects who participated in the National Health and Nutrition Examination Survey (NHANES), 1999–2016. Logistic regression and linear regression were performed after adjusting for age, sex, race, alcohol consumption, poverty-to-income ratio (PIR), body mass index (BMI), estimated glomerular filtration rate, physical activity, diabetes, cardiovascular disease, and NHANES cycle. Restricted cubic spline models were created to display the potential nonlinear association between SHS and BP levels. Results Higher risk of hypertension was found at the highest SHS concentrations (OR = 1.13, 95% CI 1.04, 1.24, P for trend = 0.007). Additionally, SHS exposure had a strong positive association with systolic blood pressure (SBP) but was negatively associated with diastolic blood pressure (DBP). Furthermore, the nonlinear model result showed a significant association between SHS and SBP (P = 0.017); however, the nonlinear model result was not significant for SHS or DBP. Conclusions Our results suggest a potential association between high SHS exposure and the risk of hypertension. Further research is needed to elucidate the underlying mechanisms. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-01009-0.
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Affiliation(s)
- Qi Zhang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Guowei Zeng
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Xiaowei Wang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Kai-Hong Wu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China.
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13
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Janjani H, Nabizadeh R, Kashani H, Shamsipour M, Aghaei M, Yunesian M. Spatiotemporal variability of exposure to secondhand smoke in Iran during 2009-2020: a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:46838-46851. [PMID: 34245414 DOI: 10.1007/s11356-021-15273-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
The present study aimed to provide a systematic review of studies on the prevalence of secondhand smoke (SHS) exposure in the Iran population as a serious indoor health hazard. A literature review of studies that considered SHS exposure, available in multiple electronic databases including Web of Science, PubMed, and Scopus published 2009-2020 in English and two Persian databases (SID and Magiran), was carried out following the PRISMA recommendations. A total of 55 studies were included based on the inclusion and exclusion criteria and the quality assessment. The results showed no specific decrease in the prevalence of exposure to secondhand smoke in Iran; however, it appeared that the exposure has been increasing. Distribution of studies in terms of age group revealed that most studies (38%) investigated adults (more than 18 years old), while 34% of the studies considered less than 18 years of age group and a single article considered infants (6-24 months). Based on the present study results, a large population of Iran was exposed to SHS. Moreover, based on Iran's STEPs 2016 (Stepwise Non-communicable Diseases Risk Factors Survey in Iran) study, the overall prevalence of SHS exposure at home (57.5%) was higher than in workplaces (49.2%). The results of the present study recommended that protection measures should be comprehensive in terms of exposure places, and since the exposure prevalence in some provinces was higher than the others, it is especially important to consider the local measures and cultural aspects in SHS control programs.
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Affiliation(s)
- Hosna Janjani
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Homa Kashani
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Aghaei
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
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14
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Mubarik S, Liu X, Malik SS, Wang L, Yu Y, Yu C. Evaluation of lifestyle risk factor differences in global patterns of breast cancer mortality and DALYs during 1990-2017 using hierarchical age-period-cohort analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:49864-49876. [PMID: 33942262 DOI: 10.1007/s11356-021-14165-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Statistical evidence on breast cancer (BC) burden related to health and lifestyle risk factors are valuable for health policy-making. This study aimed to compare the trends in BC mortality and disability adjusted life years (DALYs) attributable to various health and life style risk factors among different world's regions according to sociodemographic index (SDI). METHODS We extracted the age-standardized and age-specific rate of mortality and DALYs of women BC during 1990-2017 using the comparative risk assessment framework of the 2017 global burden of disease (GBD) study. We performed hierarchical age-period-cohort analysis to estimate age- and time-related trends, and effect of interactions between different risk factors on BC risk. RESULTS During 1990-2017, the age-standardized rate of mortality and DALYs of women BC was increasing in less developed and under developing regions. The risk factor alcohol use [RR 51.3(95%CI 17.6-149.7)] and smoking [5.9(2.0-17.3)] were significantly highly contributor to increased mortality risk in high SDI region. Whereas in the low-SDI region, the greater mortality risk was observed in alcohol use [6.9(2.4-17)] and high FPG [2.7(1.5-3.1)]-related deaths. The adjusting for individual age, period, and risk factor effects, the significant interaction effect between metabolic risk factors and older ages were observed in all SDI regions and globally as well. However, an increasing cohort effect of alcohol, high fasting plasma glucose (FPG) and smoking-related death, and DALYs was observed during 1960 to 1985 cohorts among low-SDI regions. CONCLUSIONS The age-standardized rates of mortality and DALYs due to BC has been increasing in low-SDI region. Alcohol consumption, high body mass index (BMI), high FPG, and smoking are potential BC risk factors particularly in older ages that leading to adverse disease outcomes. Therefore, rapid aging and prevalence of these prospective risk factors may strengthen the increasing mortality and DALYs of BC in low-SDI region. Hence, preventive measure along with strict action against concerned BC risk factors should be taken to reduce the disease burden specifically among lower-SDI regions.
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Affiliation(s)
- Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China.
| | - Xiaoxue Liu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | | | - Lijun Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, 30# South Renmin Road, Shiyan, 442000, Hubei, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China.
- Global Health Institute, Wuhan University, Wuhan, 430071, China.
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15
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Pader J, Ruan Y, Poirier AE, Asakawa K, Lu C, Memon S, Miller A, Walter S, Villeneuve PJ, King WD, Volesky KD, Smith L, De P, Friedenreich CM, Brenner DR. Estimates of future cancer mortality attributable to modifiable risk factors in Canada. Canadian Journal of Public Health 2021; 112:1069-1082. [PMID: 34036522 DOI: 10.17269/s41997-020-00455-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/06/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Modifiable lifestyle, environmental, and infectious risk factors associated with cancer impact both cancer incidence and mortality at the population level. Most studies estimating this burden focus on cancer incidence. However, because these risk factors are associated with cancers of disparate mortality rates, the burden associated with cancer incidence could differ from cancer mortality. Therefore, estimating the cancer mortality attributable to these risk factors provides additional insight into cancer prevention. Here, we estimated future cancer deaths and the number of avoidable deaths in Canada due to modifiable risk factors. METHODS The projected cancer mortality data came from OncoSim, a web-based microsimulation tool. These data were applied to the methodological framework that we previously used to estimate the population attributable risks and the potential impact fractions of modifiable risk factors on Canadian cancer incidence. RESULTS We estimated that most cancer deaths will be attributed to tobacco smoking with an average of 27,900 deaths annually from 2024 to 2047. If Canada's current trends in excess body weight continue, cancer deaths attributable to excess body weight would double from 2786 deaths in 2024 to 5604 deaths in 2047, becoming the second leading modifiable cause of cancer death. Applying targets to reduce these risk factors, up to 34,600 cancer deaths could be prevented from 2024 to 2047. CONCLUSION Our simulated results complement our previous findings on the cancer incidence burden since decreasing the overall burden of cancer will be accelerated through a combination of decreasing cancer incidence and improving survival outcomes through improved treatments.
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Affiliation(s)
- Joy Pader
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada
| | - Yibing Ruan
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada
| | - Abbey E Poirier
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada
| | - Keiko Asakawa
- Statistics Canada, Government of Canada, Ottawa, Ontario, Canada
| | - Chaohui Lu
- Statistics Canada, Government of Canada, Ottawa, Ontario, Canada
| | - Saima Memon
- Canadian Partnership Against Cancer, Toronto, Ontario, Canada
| | - Anthony Miller
- Canadian Partnership Against Cancer, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Stephen Walter
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Paul J Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Ontario, Canada
| | - Will D King
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Karena D Volesky
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Leah Smith
- Canadian Cancer Society, Toronto, Ontario, Canada
| | | | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Centre, Room 513C, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada. .,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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16
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Laaksonen MA, Canfell K, MacInnis RJ, Banks E, Byles JE, Giles GG, Magliano DJ, Shaw JE, Hirani V, Gill TK, Mitchell P, Cumming RG, Salagame U, Vajdic CM. The Future Burden of Head and Neck Cancers Attributable to Modifiable Behaviors in Australia: A Pooled Cohort Study. Cancer Epidemiol Biomarkers Prev 2021; 30:1566-1574. [PMID: 34020998 DOI: 10.1158/1055-9965.epi-21-0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/22/2021] [Accepted: 05/17/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Estimates of future burden of cancer attributable to current modifiable causal exposures can guide cancer prevention. We quantified future head and neck cancer burden in Australia attributable to individual and joint causal exposures, and assessed whether these burdens differ between population subgroups. METHODS We estimated the strength of the associations between exposures and head and neck cancer using adjusted proportional hazards models from pooled data from seven Australian cohorts (N = 367,058) linked to national cancer and death registries and estimated exposure prevalence from the 2017 to 2018 Australian National Health Survey. We calculated population attributable fractions (PAF) with 95% confidence intervals (CI), accounting for competing risk of death, and compared PAFs for population subgroups. RESULTS Contemporary levels of current and former smoking contribute 30.6% (95% CI, 22.7%-37.8%), alcohol consumption exceeding two standard drinks per day 12.9% (95% CI, 7.6%-17.9%), and these exposures jointly 38.5% (95% CI, 31.1%-45.0%) to the future head and neck cancer burden. Alcohol-attributable burden is triple and smoking-attributable burden is double for men compared with women. Smoking-attributable burden is also at least double for those consuming more than two alcoholic drinks daily or doing less than 150 minutes of moderate or 75 minutes of vigorous activity weekly, and for those aged under 65 years, unmarried, with low or intermediate educational attainment or lower socioeconomic status, compared with their counterparts. CONCLUSIONS Two-fifths of head and neck cancers in Australia are preventable by investment in tobacco and alcohol control. IMPACT Targeting men and other identified high-burden subgroups can help to reduce head and neck cancer burden disparities.
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Affiliation(s)
- Maarit A Laaksonen
- School of Mathematics and Statistics, University of New South Wales, Sydney, Australia.
| | - Karen Canfell
- Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Sydney, Australia
| | - Robert J MacInnis
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Emily Banks
- ANU College of Medicine, Biology and Environment, Australian National University, Canberra, Australia
| | - Julie E Byles
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, Australia
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Dianna J Magliano
- Diabetes and Population Health Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Jonathan E Shaw
- Clinical Diabetes Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Vasant Hirani
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Paul Mitchell
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Robert G Cumming
- School of Public Health, University of Sydney, Sydney, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, Australia
| | | | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
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17
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Gredner T, Mons U, Niedermaier T, Brenner H, Soerjomataram I. Impact of tobacco control policies implementation on future lung cancer incidence in Europe: An international, population-based modeling study. THE LANCET REGIONAL HEALTH. EUROPE 2021; 4:100074. [PMID: 34029359 PMCID: PMC8121752 DOI: 10.1016/j.lanepe.2021.100074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Despite recent trends in declining smoking rates, tobacco smoking remains the most preventable cause of cancer in Europe. We aimed to estimate numbers and proportions of future lung cancer cases that could be potentially prevented over a 20-year period if countries in Europe were to achieve a comprehensive implementation of tobacco control policies. METHODS Historical data from population-based cancer incidence (or mortality) was used to predict sex-specific lung cancer incidence for 30 European countries up to 2037. Hypothetical country-specific smoking prevalence that would be expected if countries would have achieved the highest-level implementation of tobacco control policies (defined by the maximum total score of the Tobacco Control Scale, TCS) was estimated by combining national prevalence data on current smoking and data on the status of implementation of key tobacco control policies. Resulting numbers and proportions of potentially preventable lung cancer cases were estimated taking into account latency periods between changes in smoking prevalence and excess cancer risks. FINDINGS In Europe, an estimated 1·65 million lung cancer cases (21·2%, 19·8% in men and 23·2% in women) could be prevented over a 20-year period with the highest-level implementation of tobacco control policies. Large variation was seen in European regions and countries reflecting the current level of tobacco control, with the largest potential for prevention in Western Europe (24·5%), Southern Europe (23·1%) and Eastern Europe (22·5%), and the lowest but still substantial potential for further prevention in Northern Europe (12·5%). In women, among whom lung cancer incidence is expected to increase, we estimated somewhat larger proportions of preventable lung cancer cases ranging from 9·9 to 33·9% as compared to men (8·6-28·5%). In the final year of study period (2037), these proportions even exceed 50% in women for some countries. INTERPRETATION Improved and expanded implementation of evidence-based tobacco control policies at the most comprehensive level could reduce future lung cancer incidence considerably across Europe. FUNDING The study was funded by the German Cancer Aid ("Deutsche Krebshilfe"), grant number 70112097.
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Affiliation(s)
- Thomas Gredner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Ute Mons
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Prevention Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Heart Center, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Tobias Niedermaier
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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18
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Maringe C, Belot A, Rachet B. Prediction of cancer survival for cohorts of patients most recently diagnosed using multi-model inference. Stat Methods Med Res 2020; 29:3605-3622. [PMID: 33019901 PMCID: PMC7543029 DOI: 10.1177/0962280220934501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Despite a large choice of models, functional forms and types of effects, the selection of excess hazard models for prediction of population cancer survival is not widespread in the literature. We propose multi-model inference based on excess hazard model(s) selected using Akaike information criteria or Bayesian information criteria for prediction and projection of cancer survival. We evaluate the properties of this approach using empirical data of patients diagnosed with breast, colon or lung cancer in 1990-2011. We artificially censor the data on 31 December 2010 and predict five-year survival for the 2010 and 2011 cohorts. We compare these predictions to the observed five-year cohort estimates of cancer survival and contrast them to predictions from an a priori selected simple model, and from the period approach. We illustrate the approach by replicating it for cohorts of patients for which stage at diagnosis and other important prognosis factors are available. We find that model-averaged predictions and projections of survival have close to minimal differences with the Pohar-Perme estimation of survival in many instances, particularly in subgroups of the population. Advantages of information-criterion based model selection include (i) transparent model-building strategy, (ii) accounting for model selection uncertainty, (iii) no a priori assumption for effects, and (iv) projections for patients outside of the sample.
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Affiliation(s)
- Camille Maringe
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
| | - Aurélien Belot
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
| | - Bernard Rachet
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
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19
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Gredner T, Niedermaier T, Brenner H, Mons U. Impact of Tobacco Control Policies on Smoking-Related Cancer Incidence in Germany 2020 to 2050-A Simulation Study. Cancer Epidemiol Biomarkers Prev 2020; 29:1413-1422. [PMID: 32457183 DOI: 10.1158/1055-9965.epi-19-1301] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/22/2020] [Accepted: 04/24/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Germany is known for its weak tobacco control. We aimed to provide projections of potentially avoidable cancer cases under different tobacco control policy intervention scenarios. METHODS To estimate numbers and proportions of potentially avoidable cancer cases under different policy intervention scenarios (cigarette price increases, comprehensive marketing ban, and plain packaging), we calculated cancer site-specific potential impact fractions by age, sex, and year of study period (2020-2050), considering latency periods between reduction in smoking prevalence and manifestation in declining cancer excess risks. To obtain estimates of future incident case numbers, we assumed a continuation of recent smoking trends, and combined German cancer registry data with forecasted population sizes, published effect sizes, and national daily smoking prevalence data. RESULTS Over a 30-year horizon, an estimated 13.3% (men 14.0% and women 12.2%) of smoking-related cancer cases could be prevented if a combination of different tobacco control policies were to be implemented in Germany, with repeated price increases being the most effective single policy (men 8.5% and women 7.3%). Extensive sensitivity analyses indicated that the model is fairly robust. CONCLUSIONS Our results suggest that the expected cancer incidence in Germany could be considerably reduced by implementing tobacco control policies as part of a primary cancer prevention strategy. IMPACT Our straightforward modeling framework enables a comparison of the impact of different health policy measures. To further accelerate the currently observed tentative trend of declining smoking prevalence in Germany and thereby curtail smoking-related cancer incidence, there is a great need to urgently intensify efforts in tobacco control.
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Affiliation(s)
- Thomas Gredner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Tobias Niedermaier
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ute Mons
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany. .,Cancer Prevention Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
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20
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Nurhasana R, Ratih SP, Djaja K, Hartono RK, Dartanto T. Passive Smokers' Support for Stronger Tobacco Control in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1942. [PMID: 32188091 PMCID: PMC7142641 DOI: 10.3390/ijerph17061942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 11/16/2022]
Abstract
Secondhand smoke exposure in Indonesia is high, especially compared to other Southeast Asian countries. Passive smoking leads to negative impacts on health and socio-economic well-being. Therefore, increasing the price of cigarettes and, thereby, increasing barriers to access to cigarettes could be an effective way to reduce smoking prevalence and protect people from second-hand smoke. This study aims to assess passive smokers' support for cigarette price increases in Indonesia. We perform a quantitative analysis with a cross-sectional design. The data were obtained through phone-based interviews of 1000 respondents aged 18 and older in Indonesia. Only 596 nonsmokers were included to be further analyzed in this study. This study found that 44.1% respondents have at least one family member who smokes. We considered the respondents' age, gender, education level, employment, and the number of people living in the respondent's household that are exposed to passive smoking. Our results demonstrate that passive smokers support stronger tobacco control such as increasing cigarette prices, regulating smoking behavior using a religious approach (Fatwa), and applying more effective pictorial health warnings.
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Affiliation(s)
- Renny Nurhasana
- Urban Studies Program, School of Strategic and Global Studies, Universitas Indonesia, Jakarta 10430, Indonesia; (R.N.); (K.D.)
- Center for Social Security Studies, Universitas Indonesia, Jakarta 10320, Indonesia
| | - Suci Puspita Ratih
- Department of Public Health, Faculty of Sports Science, Universitas Negeri Malang, Malang 65145, Indonesia
| | - Komara Djaja
- Urban Studies Program, School of Strategic and Global Studies, Universitas Indonesia, Jakarta 10430, Indonesia; (R.N.); (K.D.)
| | - Risky Kusuma Hartono
- Department of Public Health, Sekolah Tinggi Ilmu Kesehatan Indonesia Maju, Jakarta 12630, Indonesia;
| | - Teguh Dartanto
- Department of Economics, Faculty of Economics and Business, Universitas Indonesia, Depok 16424, Indonesia;
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