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Gálffy G, Szabó GT, Tamási L, Müller V, Moldvay J, Sárosi V, Kerpel-Fronius A, Kardos T, Csada E, Pápai-Székely Z, Szász Z, Király Z, Hódi G, Kovács Z, Balogh É, Kovács KA, Darida M, Buga V, Rokszin G, Abonyi-Tóth Z, Kiss Z, Vokó Z, Bogos K. Decreasing incidence and mortality of lung cancer in Hungary between 2011 and 2021 revealed by robust estimates reconciling multiple data sources. Pathol Oncol Res 2024; 30:1611754. [PMID: 38887697 PMCID: PMC11181153 DOI: 10.3389/pore.2024.1611754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/17/2024] [Indexed: 06/20/2024]
Abstract
Objective Hungary has repeatedly been shown to have the highest cancer-related mortality and incidence in Europe. Despite lung cancer being the most abundant malignant diagnosis in Hungary, numerous concerns have been raised recently regarding the bias inherent to reported incidence estimates. Re-analysis of reimbursement claims has been suggested previously by our group as an alternative approach, offering revised figures of lung cancer incidence between 2011 and 2016. Leveraging on this methodology, we aimed at updating Hungarian lung cancer incidence estimates with an additional 5 years (2017-2021), including years affected by the COVID-19 pandemic. Additionally, we also attempted to improve the robustness of estimates by taking additional characteristics of the patient pathway into account. Methods Lung cancer patients between 2011 and 2021 were identified based on reimbursement-associated ICD-10 codes, histology codes and time patterns. Multiple query architectures were tested for sensitivity and compared to official estimates of the Hungarian National Cancer Registry (HNCR). Epidemiological trends were estimated by Poisson-regression, corrected for age and sex. Results A total of 89,948 lung cancer patients diagnosed in Hungary between 2011 and 2021 have been identified by our study. In 2019 alone, 7,887 patients were diagnosed according to our optimized query. ESP2013 standardized rate was estimated between 92.5/100,000 (2011) and 78.4/100,000 (2019). In 2019, standardized incidence was 106.8/100,000 for men and 59.7/100,000 for women. Up until the COVID-19 pandemic, lung cancer incidence was decreasing by 3.18% (2.1%-4.3%) yearly in men, while there was no significant decrease in women. Young age groups (40-49 and 50-59) featured the largest improvement, but women aged 60-79 are at an increasing risk for developing lung cancer. The COVID-19 pandemic resulted in a statistically significant decrease in lung cancer incidence, especially in the 50-59 age group (both sexes). Conclusion Our results show that using an optimized approach, re-analysis of reimbursement claims yields robust estimates of lung cancer incidence. According to this approach, the incidence rate of male lung cancer is declining in Hungary, in concordance with the trend observed for lung cancer mortality. Among women aged 60-79, the incidence of lung cancer has risen, requiring more attention in the near future.
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Affiliation(s)
- Gabriella Gálffy
- Department of Pulmonology, Pulmonology Center of the Reformed Church in Hungary, Törökbálint, Hungary
| | | | - Lilla Tamási
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Veronika Müller
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Judit Moldvay
- Department of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
- Department of Pulmonology, University of Szeged Albert Szent-Györgyi Medical School, Szeged, Hungary
| | | | - Anna Kerpel-Fronius
- National Korányi Institute of Pulmonology, Department of Radiology, Budapest, Hungary
| | - Tamás Kardos
- Department of Pulmonology, University of Debrecen, Debrecen, Hungary
| | - Edit Csada
- Department of Pulmonology, University of Szeged Albert Szent-Györgyi Medical School, Szeged, Hungary
| | - Zsolt Pápai-Székely
- Fejér County Szent György, University Teaching Hospital, Székesfehérvár, Hungary
| | - Zoltán Szász
- Department of Pulmonology, Petz Aladár University Teaching Hospital, Győr, Hungary
| | - Zsolt Király
- Veszprém County Pulmonary Hospital Farkasgyepű, Farkasgyepű, Hungary
| | - Gábor Hódi
- MSD Pharma Hungary Ltd., Budapest, Hungary
| | | | - Éva Balogh
- MSD Pharma Hungary Ltd., Budapest, Hungary
| | | | | | | | | | - Zsolt Abonyi-Tóth
- RxTarget Ltd Szolnok, Szolnok, Hungary
- Department of Biostatistics, University of Veterinary Medicine, Budapest, Hungary
| | - Zoltán Kiss
- MSD Pharma Hungary Ltd., Budapest, Hungary
- 2nd Department of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, Pécs, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
- Syreon Research Institute, Budapest, Hungary
| | - Krisztina Bogos
- National Korányi Institute of Pulmonology, Budapest, Hungary
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Shanmugam R, Fulton L, Kruse CS, Beauvais B, Betancourt J, Pacheco G, Pradhan R, Sen K, Ramamonjiarivelo Z, Sharma A. The effect of COVID-19 on cancer incidences in the U.S. Heliyon 2024; 10:e28804. [PMID: 38601551 PMCID: PMC11004761 DOI: 10.1016/j.heliyon.2024.e28804] [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: 12/28/2023] [Revised: 03/10/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
Fundamental data analysis assists in the evaluation of critical questions to discern essential facts and elicit formerly invisible evidence. In this article, we provide clarity into a subtle phenomenon observed in cancer incidences throughout the time of the COVID-19 pandemic. We analyzed the cancer incidence data from the American Cancer Society [1]. We partitioned the data into three groups: the pre-COVID-19 years (2017, 2018), during the COVID-19 years (2019, 2020, 2021), and the post-COVID-19 years (2022, 2023). In a novel manner, we applied principal components analysis (PCA), computed the angles between the cancer incidence vectors, and then added lognormal probability concepts in our analysis. Our analytic results revealed that the cancer incidences shifted within each era (pre, during, and post), with a meaningful change in the cancer incidences occurring in 2020, the peak of the COVID-19 era. We defined, computed, and interpreted the exceedance probability for a cancer type to have 1000 incidences in a future year among the breast, cervical, colorectal, uterine corpus, leukemia, lung & bronchus, melanoma, Hodgkin's lymphoma, prostate, and urinary cancers. We also defined, estimated, and illustrated indices for other cancer diagnoses from the vantage point of breast cancer in pre, during, and post-COVID-19 eras. The angle vectors post the COVID-19 were 72% less than pre-pandemic and 28% less than during the pandemic. The movement of cancer vectors was dynamic between these eras, and movement greatly differed by type of cancer. A trend chart of cervical cancer showed statistical anomalies in the years 2019 and 2021. Based on our findings, a few future research directions are pointed out.
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Affiliation(s)
- Ramalingam Shanmugam
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Larry Fulton
- Boston College, Woods College of Advancing Studies, St. Mary's Hall South, Chestnut Hill, MA, 02467, USA
| | - C. Scott Kruse
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Brad Beauvais
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Jose Betancourt
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Gerardo Pacheco
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Rohit Pradhan
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Keya Sen
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Zo Ramamonjiarivelo
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Arvind Sharma
- Boston College, Woods College of Advancing Studies, St. Mary's Hall South, Chestnut Hill, MA, 02467, USA
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Worthington J, Sun Z, Fu R, Lew JB, Chan KKW, Li Q, Eskander A, Hui H, McLoughlin K, Caruana M, Peacock S, Yong JHE, Canfell K, Feletto E, Malagón T. COVID-related disruptions to colorectal cancer screening, diagnosis, and treatment could increase cancer Burden in Australia and Canada: A modelling study. PLoS One 2024; 19:e0296945. [PMID: 38557758 PMCID: PMC10984523 DOI: 10.1371/journal.pone.0296945] [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: 06/15/2023] [Accepted: 12/20/2023] [Indexed: 04/04/2024] Open
Abstract
COVID-19 disrupted cancer control worldwide, impacting preventative screening, diagnoses, and treatment services. This modelling study estimates the impact of disruptions on colorectal cancer cases and deaths in Canada and Australia, informed by data on screening, diagnosis, and treatment procedures. Modelling was used to estimate short- and long-term effects on colorectal cancer incidence and mortality, including ongoing impact of patient backlogs. A hypothetical mitigation strategy was simulated, with diagnostic and treatment capacities increased by 5% from 2022 to address backlogs. Colorectal cancer screening dropped by 40% in Canada and 6.3% in Australia in 2020. Significant decreases to diagnostic and treatment procedures were also observed in Australia and Canada, which were estimated to lead to additional patient wait times. These changes would lead to an estimated increase of 255 colorectal cancer cases and 1,820 colorectal cancer deaths in Canada and 234 cases and 1,186 deaths in Australia over 2020-2030; a 1.9% and 2.4% increase in mortality, respectively, vs a scenario with no screening disruption or diagnostic/treatment delays. Diagnostic and treatment capacity mitigation would avert 789 and 350 deaths in Canada and Australia, respectively. COVID-related disruptions had a significant impact on colorectal cancer screening, diagnostic, and treatment procedures in Canada and Australia. Modelling demonstrates that downstream effects on disease burden could be substantial. However, backlogs can be managed and deaths averted with even small increases to diagnostic and treatment capacity. Careful management of resources can improve patient outcomes after any temporary disruption, and these results can inform targeted approaches early detection of cancers.
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Affiliation(s)
| | - Zhuolu Sun
- Canadian Partnership Against Cancer, Toronto, ON, Canada
| | - Rui Fu
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jie-Bin Lew
- The Daffodil Centre, Kings Cross, New South Wales, Australia
| | - Kelvin K. W. Chan
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- Canadian Centre for Applied Research in Cancer Control, Canada
| | - Qing Li
- ICES, Toronto, Ontario, Canada
| | - Antoine Eskander
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Harriet Hui
- The Daffodil Centre, Kings Cross, New South Wales, Australia
| | | | - Michael Caruana
- The Daffodil Centre, Kings Cross, New South Wales, Australia
| | - Stuart Peacock
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- BC Cancer Canadian Centre for Applied Research in Cancer Control (ARCC), British Columbia, Canada
| | | | - Karen Canfell
- The Daffodil Centre, Kings Cross, New South Wales, Australia
| | | | - Talía Malagón
- Department of Oncology, McGill University, Montréal, Canada
- St Mary’s Research Centre, Montréal West Island CIUSSS, Montréal, Canada
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Chung SH, Rasic G, Romatoski KS, Kenzik K, Tseng JF, Sachs TE. Disparate impact of the COVID-19 pandemic on delays in colorectal cancer treatment: A National Cancer Database study. Surgery 2024; 175:1013-1020. [PMID: 38245445 DOI: 10.1016/j.surg.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/29/2023] [Accepted: 12/15/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Timely treatment for patients with colorectal cancer may have been disrupted by the COVID-19 pandemic. We evaluated the impact of the pandemic on delays to treatment with surgery or systemic therapy for patients with colorectal cancer and delineated factors predictive of delayed treatment. METHODS Using the National Cancer Database, patients diagnosed with colorectal cancer were categorized by year of diagnosis as COVID-19 era (2020) versus pre-COVID-19 (2018-2019). Categorical variables were compared by χ2 analysis. Multivariate logistic regression was used to assess odds ratios for delayed time to surgery or chemoimmunotherapy, defined as >60 days. RESULTS In total, 50,689 patients colorectal cancer were diagnosed patients who were pre-COVID-19 vs 21,331 within the COVID-19-era. Patients diagnosed with COVID-19 had a higher stage at diagnosis. There were no differences in the proportion of delayed time to surgery for patients diagnosed in 2020, but patients who were tested for COVID-19 had increased proportions of delayed time to surgery (P < .0001). In multivariate analysis, Black race (P = .0026) and uninsured/underinsured status (P = .0017) were associated with delayed time to surgery. Diagnosis during COVID-19 did not increase delayed time to chemoimmunotherapy, regardless of COVID-19 testing or positivity; however, delays were seen for Black (P < .0001), Hispanic (P < .0001), and uninsured/underinsured patients (P < .0001). CONCLUSION Although the pandemic did not delay treatment for colorectal cancer overall, vulnerable and underserved populations were disproportionately affected by delays to all forms of therapy. The difference in colorectal cancer outcomes in the coming years as a result of delays in treatment may be significant for these patients.
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Affiliation(s)
- Sophie H Chung
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA. https://twitter.com/SophieChung91
| | - Gordana Rasic
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA. https://twitter.com/GordanaRasic
| | - Kelsey S Romatoski
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA. https://twitter.com/KelseyRomatoski
| | - Kelly Kenzik
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA
| | - Jennifer F Tseng
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA. https://twitter.com/TsengJennifer
| | - Teviah E Sachs
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA.
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Giladi O, Bagnato G, Gentilini M, Shimony S, Pasvolsky O, Berger T, Itchaki G, Raanani P, Lolli G, Stefoni V, Broccoli A, Argnani L, Zinzani PL, Gurion R. Diffuse large B cell lymphoma characteristics and outcomes during the COVID-19 pandemic in two tertiary centers - an Israeli/ Italian study. Ann Hematol 2024; 103:803-811. [PMID: 37950052 DOI: 10.1007/s00277-023-05543-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023]
Abstract
The COVID-19 pandemic posed a major challenge in cancer care worldwide which might have an impact on the management of diffuse large B-cell lymphoma (DLBCL). We conducted a retrospective study comparing characteristics, management, and outcomes of DLBCL patients diagnosed during the first year of the COVID-19 pandemic (1/3/2020-28/2/2021) to those diagnosed in the previous year (1/3/2019-28/2/2020) in two tertiary centers in Italy and Israel. 182 patients were diagnosed with DLBCL during the study period. More patients were diagnosed during the pandemic compared to the year before: 60 vs. 29 and 54 vs. 39 in Italy and in Israel, respectively. Trends towards older age and higher transformation rates were shown during the pandemic. The interval between the initiation of symptoms and diagnosis was longer during the pandemic. Five and four patients were diagnosed with COVID-19 during treatment in Italy and in Israel, respectively. there was no difference in dose density and intensity of treatment, before and during the pandemic. The median follow-up during and before the pandemic was 15.2 and 25.5 months, respectively. Progression-free survival (PFS) was slightly shorter during the pandemic compared to the year before (64.9% vs. 70.6%; p = 0.0499). In multivariate analysis, older age and transformed disease were independently related to PFS, while diagnosis of DLBCL during the pandemic was not. Despite the challenges caused by COVID-19 pandemic, the management of DLBCL patients remained unchanged including dose density and intensity. Nevertheless, a shorter PFS during the outbreak might be attributed to differences in patients' characteristics.
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Affiliation(s)
- Odil Giladi
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel.
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Gianmarco Bagnato
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Marianna Gentilini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Shai Shimony
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Oren Pasvolsky
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Tamar Berger
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Laboratory of Genome Maintenance, The Rockefeller University, New York, NY, USA
| | - Gilad Itchaki
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Hematology Institute, Meir Medical Center, Kfar Saba, Israel
| | - Pia Raanani
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ginerva Lolli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Vittorio Stefoni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Alessandro Broccoli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Lisa Argnani
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Ronit Gurion
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Luo Q, Steinberg J, Kahn C, Caruana M, Grogan PB, Page A, Ivers R, Banks E, O'Connell DL, Canfell K. Trends and projections of cause-specific premature mortality in Australia to 2044: a statistical modelling study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:100987. [PMID: 38456088 PMCID: PMC10920049 DOI: 10.1016/j.lanwpc.2023.100987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/27/2023] [Accepted: 11/28/2023] [Indexed: 03/09/2024]
Abstract
Background Long-term projections of premature mortality (defined as deaths age <75 years) help to inform decisions about public health priorities. This study aimed to project premature mortality rates in Australia to 2044, and to estimate numbers of deaths and potential years of life lost (PYLL) due to premature mortality overall and for 59 causes. Methods We examined the past trends in premature mortality rates using Australian mortality data by sex, 5-year age group and 5-year calendar period up to 2019. Cigarette smoking exposure data (1945-2019) were included to project lung cancer mortality. Age-period-cohort or generalised linear models were developed and validated for each cause to project premature mortality rates to 2044. Findings Over the 25-year period from 1990-1994 to 2015-2019, there was a 44.4% decrease in the overall age-standardised premature mortality rate. This decline is expected to continue, from 162.4 deaths/100,000 population in 2015-2019 to 141.7/100,000 in 2040-2044 (12.7% decrease). Despite declining rates, total numbers of premature deaths are projected to increase by 22.8%, rising from 272,815 deaths in 2015-2019 to 334,894 deaths in 2040-2044. This is expected to result in 1.58 million premature deaths over the 25-year period 2020-2044, accounting for 24.5 million PYLL. Of the high-level cause categories, cancer is projected to remain the most common cause of premature death in Australia by 2044, followed by cardiovascular disease, external causes (including injury, poisoning, and suicide), and respiratory diseases. Interpretation Despite continuously declining overall premature mortality rates, the total number of premature deaths in Australia is projected to remain substantial, and cancer will continue to be the leading cause. These projections can inform the targeting of public health efforts and can serve as benchmarks against which to measure the impact of future interventions. They emphasise the ongoing importance of accelerating the prevention, early detection, and treatment of key health conditions. Funding No funding was provided for this study.
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Affiliation(s)
- Qingwei Luo
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Clare Kahn
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Paul B. Grogan
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Dianne L. O'Connell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
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Xu X, Shi Z, Zhou L, Lin J, Atlantis E, Chen X, Hussain A, Wang Y, Wang Y. Impact of COVID-19 on risks and deaths of non-communicable diseases in the Western Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:100795. [PMID: 38456087 PMCID: PMC10920048 DOI: 10.1016/j.lanwpc.2023.100795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/08/2023] [Accepted: 05/04/2023] [Indexed: 03/09/2024]
Abstract
Countries and areas in the Western Pacific region (WPR) experienced the COVID-19 pandemic and took various preventive measures, which affected non-communicable diseases (NCDs) risks and mortality. Due to differences in COVID-19 prevention measures and other characteristics such as culture, religions, political systems, socioeconomic development, lifestyles, and health care systems, the effects of COVID-19 on NCDs varied greatly among WPR countries. Most countries had an increased all-cause and NCDs mortality during the pandemic, but some developed countries, including New Zealand, Singapore and Australia reported decreased mortality. The pandemic and the preventive measures increased NCD risk factors including unhealthy diet, lack of physical activity and sleep disorders. The effects varied by socioeconomic status and health conditions. COVID-19 related stress, food shortages, and confined lifestyle had immediate detrimental effects on NCDs, and also affected pregnancy outcomes with long-term effects on NCDs risks in coming years.
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Affiliation(s)
- Xiaoyue Xu
- School of Population Heath, University of New South Wales, Australia
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
| | - Lihui Zhou
- School of Public Health, Tianjin Medical University, Tianjin, People's Republic of China
| | - Jing Lin
- School of Public Health, Tianjin Medical University, Tianjin, People's Republic of China
| | - Evan Atlantis
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
- Discipline of Medicine, Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Nepean, New South Wales, Australia
| | - Xinguang Chen
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, International Obesity and Metabolic Disease Research Center, Xi’an Jiaotong University, Xi’an 710061, People’s Republic of China
| | - Akhtar Hussain
- Faculty of Health Sciences, Nord University, Bodø, 8049, Norway
- International Diabetes Federation, 166 Chaussee de La Hulpe, B-1170, Brussels, Belgium
| | - Youfa Wang
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, International Obesity and Metabolic Disease Research Center, Xi’an Jiaotong University, Xi’an 710061, People’s Republic of China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, People's Republic of China
- National Institute of Health Data Science at Peking University, Peking University, Beijing, People's Republic of China
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8
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Uddin MMN, Bekmukhametova A, Antony A, Barman SK, Houang J, Wu MJ, Hook JM, George L, Wuhrer R, Mawad D, Ta D, Ruprai H, Lauto A. Encapsulated Rose Bengal Enhances the Photodynamic Treatment of Triple-Negative Breast Cancer Cells. Molecules 2024; 29:546. [PMID: 38276623 PMCID: PMC10820979 DOI: 10.3390/molecules29020546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
Among breast cancer subtypes, triple-negative breast cancer stands out as the most aggressive, with patients facing a 40% mortality rate within the initial five years. The limited treatment options and unfavourable prognosis for triple-negative patients necessitate the development of novel therapeutic strategies. Photodynamic therapy (PDT) is an alternative treatment that can effectively target triple-negative neoplastic cells such as MDA-MB-231. In this in vitro study, we conducted a comparative analysis of the PDT killing rate of unbound Rose Bengal (RB) in solution versus RB-encapsulated chitosan nanoparticles to determine the most effective approach for inducing cytotoxicity at low laser powers (90 mW, 50 mW, 25 mW and 10 mW) and RB concentrations (50 µg/mL, 25 µg/mL, 10 µg/mL and 5 µg/mL). Intracellular singlet oxygen production and cell uptake were also determined for both treatment modalities. Dark toxicity was also assessed for normal breast cells. Despite the low laser power and concentration of nanoparticles (10 mW and 5 µg/mL), MDA-MB-231 cells experienced a substantial reduction in viability (8 ± 1%) compared to those treated with RB solution (38 ± 10%). RB nanoparticles demonstrated higher singlet oxygen production and greater uptake by cancer cells than RB solutions. Moreover, RB nanoparticles display strong cytocompatibility with normal breast cells (MCF-10A). The low activation threshold may be a crucial advantage for specifically targeting malignant cells in deep tissues.
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Affiliation(s)
- Mir Muhammad Nasir Uddin
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
- Department of Pharmacy, Faculty of Biological Sciences, University of Chittagong, Chittagong 4331, Bangladesh
| | | | - Anu Antony
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - Shital K. Barman
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - Jessica Houang
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - Ming J. Wu
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - James M. Hook
- School of Chemistry, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Laurel George
- Advanced Materials Characterisation Facility, Western Sydney University, Penrith, NSW 2750, Australia
| | - Richard Wuhrer
- Advanced Materials Characterisation Facility, Western Sydney University, Penrith, NSW 2750, Australia
| | - Damia Mawad
- School of Materials Science and Engineering and Australian Centre for NanoMedicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Daniel Ta
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - Herleen Ruprai
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
| | - Antonio Lauto
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia
- Biomedical Engineering & Neuroscience Research Group, The MARCS Institute, Western Sydney University, Penrith, NSW 2750, Australia
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Kim U, Koroukian S, Rose J, Hoehn RS, Carroll BT. US Cancer Detection Decreased Nearly 9 Percent During The First Year Of The COVID-19 Pandemic. Health Aff (Millwood) 2024; 43:125-130. [PMID: 38190599 DOI: 10.1377/hlthaff.2023.00767] [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: 01/10/2024]
Abstract
We investigated the impact of the COVID-19 pandemic on cancer detection, using data from the Surveillance, Epidemiology, and End Results Program, which recently released data through the first year of the pandemic (2020). Across all cancer sites, cancer incidence fell by 8.7 percent. The most common cancers that experienced the largest disruptions were lung and bronchus, melanoma of the skin, and thyroid cancer.
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Affiliation(s)
- Uriel Kim
- Uriel Kim , Case Western Reserve University, Cleveland, Ohio
| | | | - Johnie Rose
- Johnie Rose, Case Western Reserve University
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10
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Chen J, Qiu Y, Wu W, Yang R, Li L, Yang Y, Yang X, Xu L. Trends and Projection of the Incidence of Active Pulmonary Tuberculosis in Southwestern China: Age-Period-Cohort Analysis. JMIR Public Health Surveill 2023; 9:e48015. [PMID: 38157236 PMCID: PMC10787335 DOI: 10.2196/48015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/19/2023] [Accepted: 10/31/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND The control of pulmonary tuberculosis (PTB) is critical for achieving the vision of World Health Organization's End TB goal. OBJECTIVE This study analyzes the temporal trends in PTB incidence associated with age, period, and birth cohorts from 2006 to 2020 in Yunnan, China; projects the PTB burden till 2030; and explores the drivers of PTB incidence. METHODS The aggregated PTB incidence rates between 2005 and 2020 were obtained from the National Notifiable Disease Reporting System. We used the age-period-cohort model to evaluate the age, period, and cohort effects on PTB incidence. We applied the Bayesian age-period-cohort model to project future PTB incidence from 2021 to 2030. We applied the decomposition algorithm to attribute the incidence trends to population aging, population growth, and age-specific changes from 2006 to 2030. RESULTS From 2006 to 2020, the PTB incidence in Yunnan was relatively stable, although the absolute number showed an increase. The net drift was -1.56% (95% CI -2.41% to -0.70%). An M-shaped bimodal local drift and a longitudinal age curve were observed. The overall local drift was below zero for most age groups except for the age groups of 15-19 years (2.37%, 95% CI -0.28% to 5.09%) and 50-54 years (0.41%, 95% CI -1.78% to 2.64%). The highest risk of PTB incidence was observed in the age group of 65-69 years, and another peak was observed in the age group of 20-24 years. Downward trends were observed for both period and cohort effects, but the cohort effect trends were uneven. A higher risk was observed for the birth cohorts of 1961-1970 (rate ratio [RR]1961-1965=1.10, 95% CI 0.88-1.38; RR1966-1970=1.11, 95% CI 0.92-1.37) and 2001-2010 (RR2001-2005=0.92, 95% CI 0.63-1.34; RR2006-2010=0.84, 95% CI 0.45-1.58) than for the adjacent cohorts. The Bayesian age-period-cohort model projected that PTB incidence will continually increase from 2021 to 2030 and that PTB incidence in 2030 will be 2.28 times higher than that in 2006. The age-specific change was the leading cause for the growing PTB disease burden. CONCLUSIONS Although there are several levels and measures for PTB control, the disease burden is likely to increase in the future. To bridge the gap of TB-free vision, our study suggests that public health policies be put in place soon, including large-scale active case-finding, priority prevention policies for high-risk older adult and young adult populations, and reduction of possible grandparent-grandchildren transmission patterns.
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Affiliation(s)
- Jinou Chen
- Division of Tuberculosis Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Yubing Qiu
- Division of Tuberculosis Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Wei Wu
- Division of Tuberculosis Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Rui Yang
- Division of Tuberculosis Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Ling Li
- Division of Tuberculosis Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Yunbin Yang
- Division of Tuberculosis Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Xing Yang
- Division of Tuberculosis Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Lin Xu
- Division of Tuberculosis Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, China
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11
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Fefferman M, Kuchta K, Wang C, Nicholson K, Kopkash K, Pesce C, Poli E, Smith TW, Yao K. Rates of newly diagnosed breast cancer at commission on cancer facilities during the early phase of the COVID-19 pandemic. Cancer Med 2023; 13:e6874. [PMID: 38140789 PMCID: PMC10807625 DOI: 10.1002/cam4.6874] [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: 06/26/2023] [Revised: 11/02/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION The objective of this study was to examine the impact of the early part of the COVID-19 pandemic on the number of newly diagnosed breast cancer cases at Commission on Cancer (CoC)-accredited facilities relative to the United States (U.S.) population. METHODS We examined the incidence of breast cancer cases at CoC sites using the U.S. Census population as the denominator. Breast cancer incidence was stratified by patient age, race and ethnicity, and geographic location. RESULTS A total of 1,499,806 patients with breast cancer were included. For females, breast cancer cases per 100,000 individuals went from 188 in 2015 to 203 in 2019 and then dropped to 176 in 2020 with a 15.7% decrease from 2019 to 2020. Breast cancer cases per 100,000 males went from 1.7 in 2015 to 1.8 in 2019 and then declined to 1.5 in 2020 with a 21.8% decrease from 2019 to 2020. For both females and males, cases per 100,000 individuals decreased from 2019 to 2020 for almost all age groups. For females, rates dropped from 2019 to 2020 for all races and ethnicities and geographic locations. The largest percent change was seen among Hispanic patients (-18.4%) and patients in the Middle Atlantic division (-18.6%). The stage distribution (0-IV) for female and male patients remained stable from 2018 to 2020. CONCLUSION The first year of the COVID-19 pandemic was associated with a decreased number of newly diagnosed breast cancer cases at Commission on Cancer sites.
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Affiliation(s)
- Marie Fefferman
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Kristine Kuchta
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
| | - Chi‐Hsiung Wang
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
| | - Kyra Nicholson
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Katherine Kopkash
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Catherine Pesce
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Elizabeth Poli
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Thomas W. Smith
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
| | - Katharine Yao
- Department of SurgeryNorthShore University Health System, Evanston HospitalEvanstonIllinoisUSA
- Department of SurgeryUniversity of Chicago, Pritzker School of MedicineChicagoIllinoisUSA
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12
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Trojanowski M, Radomyski P, Kycler W, Michalek IM. Decrease in the number of new cancer diagnoses during the first year of the COVID-19 pandemic - cohort study of 3.5 million individuals in western Poland. Front Oncol 2023; 13:1230289. [PMID: 38179170 PMCID: PMC10765942 DOI: 10.3389/fonc.2023.1230289] [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: 06/21/2023] [Accepted: 11/13/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction The COVID-19 pandemic has considerably affected healthcare systems worldwide and is expected to influence cancer incidence, mortality, stage at diagnosis, and survival. This study aimed to assess COVID-19-related changes in cancer incidence observed in 2020 in the Greater Poland region. Materials and methods Data from the Greater Poland Cancer Registry on cancer patients diagnosed between 2010 and 2020 were analysed. To quantify the change in the number of incident cancer cases during the COVID-19 pandemic, we calculated the standardized incidence ratio (SIR) and the incidence rate difference (IRD) to assume the pandemic-attributable gap in cancer incidence. Results In 2020, in Greater Poland, the expected number of new cancer cases was 18 154 (9 226 among males and 8 927 among females), while the observed number was 14 770 (7 336 among males and 7 434 among females). The registered number of cancer cases decreased in 2020 by 20% (SIR 0·80, 95% CI 0·78 to 0·81) and 17% (SIR 0·83, 95% CI 0·81 to 0·85) in males and females, respectively. Among men, the most significant difference was reported for myeloma (SIR 0·59, 95% CI 0·45 to 0·77), among women for bone cancer (SIR 0·47, 95% CI 0·20 to 0·93). In females the observed incidence was higher than expected for cancer of an unspecified site (SIR 1·19, 95% CI 1·01 to 1·38). In our study, the decrease in new cancer cases was greater in males than in females. Discussion The observed incidence was affected in most cancer sites, with the most significant deviation from the expected number in the case of myeloma. An increase in the observed incidence was reported only in women diagnosed with cancer of an unspecified site, which might reflect shortages in access to oncological diagnostics.
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Affiliation(s)
- Maciej Trojanowski
- Greater Poland Cancer Registry, Greater Poland Cancer Centre, Poznan, Poland
| | - Piotr Radomyski
- Radiology Department, Greater Poland Cancer Centre, Poznan, Poland
- Electroradiology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Witold Kycler
- Gastrointestinal Surgical Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Irmina Maria Michalek
- Cancer Epidemiology and Primary Prevention Department, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Tambuyzer T, Vanhauwaert D, Boterberg T, De Vleeschouwer S, Peacock HM, Bouchat J, Silversmit G, Verdoodt F, De Gendt C, Van Eycken L. Impact of the COVID-19 Pandemic on Incidence and Observed Survival of Malignant Brain Tumors in Belgium. Cancers (Basel) 2023; 16:63. [PMID: 38201490 PMCID: PMC10778220 DOI: 10.3390/cancers16010063] [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: 11/07/2023] [Revised: 12/15/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: This study evaluates the impact of the COVID-19 pandemic on the incidence, treatment, and survival of adults diagnosed with malignant brain tumors in Belgium in 2020. (2) Methods: We examined patients aged 20 and older with malignant brain tumors (2004-2020) from the Belgian Cancer Registry database, assessing incidence, WHO performance status, vital status, and treatment data. We compared 2020 incidence rates with projected rates and age-standardized rates to 2015-2019. The Kaplan-Meier method was used to assess observed survival (OS). (3) Results: In 2020, there was an 8% drop in age-specific incidence rates, particularly for those over 50. Incidence rates plunged by 37% in April 2020 during the first COVID-19 peak but partially recovered by July. For all malignant brain tumors together, the two-year OS decreased by four percentage points (p.p.) in 2020 and three p.p. in 2019, compared to that in 2015-2018. Fewer patients (-9 p.p.) with glioblastoma underwent surgery, and the proportion of patients not receiving surgery, radiotherapy, or systemic therapy increased by six percentage points in 2020. (4) Conclusions: The COVID-19 pandemic profoundly impacted the diagnosis, treatment strategies, and survival of brain tumor patients in Belgium during 2020. These findings should guide policymakers in future outbreak responses, emphasizing the need to maintain or adapt (neuro)-oncological care pathways and promote informed decision making when care capacity is limited.
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Affiliation(s)
- Tim Tambuyzer
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | | | - Tom Boterberg
- Department of Radiation Oncology, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Steven De Vleeschouwer
- Department of Neurosurgery, UZ Leuven, 3000 Leuven, Belgium;
- Laboratory of Experimental Neurosurgery and Neuroanatomy, Department Neurosciences, LEUVEN BRAIN INSTITUTE (LBI), KU Leuven, 3000 Leuven, Belgium
| | - Hanna M. Peacock
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | - Joanna Bouchat
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | - Geert Silversmit
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | - Freija Verdoodt
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | - Cindy De Gendt
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | - Liesbet Van Eycken
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
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Nguyen PT, Hori M, Matsuda T, Katanoda K. Cancer Prevalence Projections in Japan and Decomposition Analysis of Changes in Cancer Burden, 2020-2050: A Statistical Modeling Study. Cancer Epidemiol Biomarkers Prev 2023; 32:1756-1770. [PMID: 37756571 PMCID: PMC10690142 DOI: 10.1158/1055-9965.epi-23-0754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/02/2023] [Accepted: 09/25/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND We provide comprehensive sex-stratified projections of cancer prevalence for 22 cancer sites in Japan from 2020 to 2050. METHODS Using a scenario-based approach, we projected cancer prevalence by combining projected incidence cases and survival probabilities. Age-specific incidences were forecasted using age-period-cohort models, while survival rates were estimated using a period-analysis approach and multiple parametric survival models. To understand changes in cancer prevalence, decomposition analysis was conducted, assessing the contributions of incidence, survival, and population demographics. RESULTS By 2050, cancer prevalence in Japan is projected to reach 3,665,900 (3,210,200 to 4,201,400) thousand cases, representing a 13.1% increase from 2020. This rise is primarily due to a significant increase in female survivors (+27.6%) compared with a modest increase in males (+0.8%), resulting in females overtaking males in prevalence counts from 2040 onward. In 2050, the projected most prevalent cancer sites in Japan include colorectal, female breast, prostate, lung, and stomach cancers, accounting for 66.4% of all survivors. Among males, the highest absolute increases in prevalence are projected for prostate, lung, and malignant lymphoma cancers, while among females, the highest absolute increases are expected for female breast, colorectal, and corpus uteri cancers. CONCLUSIONS These findings emphasize the evolving cancer prevalence, influenced by aging populations, changes in cancer incidence rates, and improved survival. Effective prevention, detection, and treatment strategies are crucial to address the growing cancer burden. IMPACT This study contributes to comprehensive cancer control strategies and ensures sufficient support for cancer survivors in Japan.
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Affiliation(s)
- Phuong The Nguyen
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Megumi Hori
- School of Nursing, University of Shizuoka, Shizuoka, Japan
| | - Tomohiro Matsuda
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Kota Katanoda
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
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15
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Canfell K, Chiam K, Nickson C, Mann GB. The complex impact of COVID-19 on cancer outcomes in Australia. Med J Aust 2023; 219:402-404. [PMID: 37852608 DOI: 10.5694/mja2.52125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023]
Affiliation(s)
- Karen Canfell
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW
| | - Karen Chiam
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW
| | - Carolyn Nickson
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - G Bruce Mann
- Breast Service, Royal Melbourne and Royal Women's Hospitals, Melbourne, VIC
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16
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Xiao H, Liu F, Unger JM. Dynamic zero-COVID policy and healthcare utilization patterns in China during the Shanghai COVID-19 Omicron outbreak. COMMUNICATIONS MEDICINE 2023; 3:143. [PMID: 37821531 PMCID: PMC10567791 DOI: 10.1038/s43856-023-00375-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND In April 2022, an outbreak of the SARS-CoV-2 virus Omicron variant in Shanghai precipitated an extensive lockdown. We assessed changes in healthcare utilization during this outbreak and investigated the relationship between the stringency of mitigation strategies and disruptions in healthcare utilization. METHODS Using provincial-level data from routine health information systems covering all hospitals across Mainland China, we conducted an interrupted time series analysis to examine changes in healthcare utilization during the Shanghai outbreak. Linear regression was used to evaluate the direction and magnitude of the association between the relative changes in the move-out movement index, a proxy for the stringency in population-level mitigation strategies, and the estimated relative changes in healthcare utilization. RESULTS Overall, there were 22.9 billion outpatient visits and 1.2 billion discharged inpatients during the study period from January 2016 to May 2022, including 9.1 billion (39.7%) and 0.46 billion (38.2%) in the post-COVID-19 period (January 2020-May 2022), respectively. From March through May 2022, the outbreak resulted in an accumulative loss of 23.5 million (47%) outpatient visits and 0.6 million (55%) discharged inpatients in Shanghai, and a loss of 150.3 million (14%) outpatient visits and 3.6 million (7%) discharged inpatients in other regions. We find that for every 10-percentage point reduction in the relative change of move-out index, a 2.7 (95% CI: 2.0-3.4) percentage point decline in the relative change of outpatient visits, and a 4.3 (95% CI: 3.5-5.2) percentage points decline in the relative change of inpatient discharges. CONCLUSIONS The Shanghai COVID-19 Omicron outbreak associates with a substantial reduction in outpatient visits and inpatient discharges within Shanghai and other regions in China. The stringency of the COVID-19 lockdown policies associates with more profound reductions in healthcare utilization.
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Affiliation(s)
- Hong Xiao
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
| | - Fang Liu
- Independent Researcher, Beijing, China
| | - Joseph M Unger
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
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17
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Cesnik R, Toohey K, Freene N, Kunstler B, Semple S. Physical Activity Levels in People with Cancer Undergoing Chemotherapy: A Systematic Review. Semin Oncol Nurs 2023; 39:151435. [PMID: 37127520 DOI: 10.1016/j.soncn.2023.151435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/22/2023] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Physical activity (PA) has been shown to improve chemotherapy side effects, survival rates and treatment adherence in people with cancer. This review aimed to identify whether people undergoing chemotherapy in different exercise interventions meet PA guidelines during chemotherapy. DATA SOURCES Databases searched were CINAHL complete, PubMed, Cochrane Library, EMBASE, AMED, Joanna Briggs Institute, OVID MEDLINE, and Google Scholar. Eligibility and risk-of-bias were reviewed by two authors. PROSPERO registration: CRD42018093839. CONCLUSION Thirty-three studies were eligible (14 randomized controlled trials, six pre-post, and 13 cross-sectional studies), which included 2,722 people with cancer undergoing chemotherapy. Studies (n = 11/13) found PA interventions successfully increased or maintained PA participation levels, whereas PA declined without intervention. This review has identified that due to limited evidence it is not possible to determine the most appropriate intervention to improve PA for people undergoing chemotherapy. Despite the well-documented benefits of PA, most people undergoing chemotherapy do not achieve the PA guidelines. Clinicians should be aware that during treatment, participants may not meet PA guidelines even if they participate in an intervention. However, interventions may prevent PA levels from declining. Further research is required to determine the most effective approaches to increase PA levels while undergoing chemotherapy. IMPLICATIONS FOR NURSING PRACTICE Nurses are well placed to have conversations with patients undergoing chemotherapy regarding PA levels. PA should be considered as part of a treatment regimen. Tailored advice must be provided aiming to improve health outcomes. Referral to an exercise professional is best practice to improve the uptake of PA.
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Affiliation(s)
- Rebecca Cesnik
- PhD Candidate, ACT Health, ACT, Australia; Professor, Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, ACT, Australia; Assistant Professor, Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT, Australia
| | - Kellie Toohey
- Professor, Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, ACT, Australia; Assistant Professor, Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT, Australia.
| | - Nicole Freene
- Associate Professor, Physiotherapy, Faculty of Health, University of Canberra, Bruce, ACT, Australia; Associate Professor, Health Research Institute, University of Canberra, Bruce, ACT, Australia
| | - Brea Kunstler
- Research Fellow, BehaviourWorks, Monash University, Victoria, Australia
| | - Stuart Semple
- Professor, Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, ACT, Australia; Associate Professor, Health Research Institute, University of Canberra, Bruce, ACT, Australia; Professor, Research Institute of Sport and Exercise, University of Canberra, Bruce, ACT, Australia
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18
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Negoita SI, Ionescu RV, Zlati ML, Antohi VM, Nechifor A. New Regional Dynamic Cancer Model across the European Union. Cancers (Basel) 2023; 15:cancers15092545. [PMID: 37174011 PMCID: PMC10177237 DOI: 10.3390/cancers15092545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/23/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Can increasing levels of economic wealth significantly influence changes in cancer incidence and mortality rates? METHODS We investigated this issue by means of regression analyses based on the study of incidence and mortality indicators for lip, oral cavity, and pharyngeal; colon; pancreatic; lung; leukaemia; brain and central nervous system cancers in correlation with the levels of economic welfare and financial allocations to health at the level of the European Union member states, with the exception of Luxembourg and Cyprus for which there are no official statistical data reported. RESULTS The results of the study showed that there were significant disparities both regionally and by gender, requiring corrective public policy measures that were formulated in this study. CONCLUSIONS The conclusions highlight the main findings of the study in terms of the evolution of the disease, present the significant aspects that characterise the evolution of each type of cancer during the period analysed (1993-2021), and highlight the novelty and limitations of the study and future directions of research. As a result, increasing economic welfare is a potential factor in halting the effects of cancer incidence and mortality at the population level, while the financial allocations to health of EU member countries' budgets are a drawback due to large regional disparities.
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Affiliation(s)
- Silvius Ioan Negoita
- Anaesthesia Intensive Care Unit, Department Orthopedics, University of Medicine and Pharmacy Carol Davila of Bucharest, 020021 Bucharest, Romania
| | - Romeo Victor Ionescu
- Department of Administrative Sciences and Regional Studies, Dunarea de Jos University of Galati, 800008 Galati, Romania
| | - Monica Laura Zlati
- Department of Business Administration, Dunarea de Jos University of Galati, 800008 Galati, Romania
| | - Valentin Marian Antohi
- Department of Business Administration, Dunarea de Jos University of Galati, 800008 Galati, Romania
- Departament of Finance, Accounting and Economic Theory, Transilvania University of Brasov, 500036 Galati, Romania
| | - Alexandru Nechifor
- Department of Medical Clinical, Dunarea de Jos University of Galati, 800008 Galati, Romania
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19
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Fu R, Sutradhar R, Li Q, Kamalraj P, Dare A, Hanna TP, Chan KKW, Irish JC, Coburn N, Hallet J, Singh S, Parmar A, Earle CC, Lapointe-Shaw L, Krzyzanowska MK, Louie AV, Mahar A, Urbach DR, McIsaac DI, Enepekides D, Gomez D, Look Hong NJ, Tinmouth J, Eskander A. Early survival for patients newly diagnosed with cancer during COVID-19 in Ontario, Canada: A population-based cohort study. Cancer Med 2023. [PMID: 36999960 DOI: 10.1002/cam4.5861] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/15/2023] [Accepted: 03/16/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Little is known about the association between the COVID-19 pandemic and early survival among newly diagnosed cancer patients. METHODS This retrospective population-based cohort study used linked administrative datasets from Ontario, Canada. Adults (≥18 years) who received a cancer diagnosis between March 15 and December 31, 2020, were included in a pandemic cohort, while those diagnosed during the same dates in 2018/2019 were included in a pre-pandemic cohort. All patients were followed for one full year after the date of diagnosis. Cox proportional hazards regression models were used to assess survival in relation to the pandemic, patient characteristics at diagnosis, and the modality of first cancer treatment as a time-varying covariate. Interaction terms were explored to measure the pandemic association with survival for each cancer type. RESULTS Among 179,746 patients, 53,387 (29.7%) were in the pandemic cohort and 37,741 (21.0%) died over the first post-diagnosis year. No association between the pandemic and survival was found when adjusting for patient characteristics at diagnosis (HR 0.99 [95% CI 0.96-1.01]), while marginally better survival was found for the pandemic cohort when the modality of treatment was additionally considered (HR 0.97 [95% CI 0.95-0.99]). When examining each cancer type, only a new melanoma diagnosis was associated with a worse survival in the pandemic cohort (HR 1.25 [95% CI 1.05-1.49]). CONCLUSIONS Among patients able to receive a cancer diagnosis during the pandemic, one-year overall survival was not different than those diagnosed in the previous 2 years. This study highlights the complex nature of the COVID-19 pandemic impact on cancer care.
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Affiliation(s)
- Rui Fu
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Qing Li
- ICES, Toronto, Ontario, Canada
| | - Pabiththa Kamalraj
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Anna Dare
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Timothy P Hanna
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
- Ontario Institute for Cancer Research (OICR), Toronto, Ontario, Canada
| | - Kelvin K W Chan
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Ontario Health-Cancer Care Ontario, Toronto, Ontario, Canada
| | - Jonathan C Irish
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Natalie Coburn
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Julie Hallet
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Ontario Institute for Cancer Research (OICR), Toronto, Ontario, Canada
| | - Simron Singh
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ambica Parmar
- ICES, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Craig C Earle
- ICES, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lauren Lapointe-Shaw
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Monika K Krzyzanowska
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alexander V Louie
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Alyson Mahar
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - David R Urbach
- ICES, Toronto, Ontario, Canada
- Department of Surgery, Women's College Hospital, Toronto, Ontario, Canada
| | - Daniel I McIsaac
- ICES, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Danny Enepekides
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - David Gomez
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of General Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Nicole J Look Hong
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jill Tinmouth
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Ontario Health-Cancer Care Ontario, Toronto, Ontario, Canada
| | - Antoine Eskander
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
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20
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Ramírez-Soto MC, Salazar-Peña M, Vargas-Herrera J. Estimating Excess Mortality Due to Prostate, Breast, and Uterus Cancer during the COVID-19 Pandemic in Peru: A Time Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5156. [PMID: 36982065 PMCID: PMC10049374 DOI: 10.3390/ijerph20065156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
During the COVID-19 pandemic, most of the deaths in Peru were related to COVID-19; however, cancer deaths have also been exacerbated in the first months of the pandemic. Despite this, excess mortalities of prostate, breast, and uterus cancer are not available by age group and region from January to December 2020. Therefore, we estimated the excess deaths and excess death rates (per 100,000 habitants) due to prostate, breast, and uterus cancer in 25 Peruvian regions. We did a time series analysis. Prostate, breast, and uterus cancer death data for 25 Peruvian regions were retrieved during the COVID-19 pandemic in 2020, as well as data for up to 3 years prior (2017-2019) from the Sistema Informatico Nacional de Defunciones at the Ministry of Health of Peru. Deaths in 2020 were defined as observed deaths. The expected deaths (in 2020) were estimated using the average deaths over 3 preceding years (2017, 2018 and 2019). Excess mortality was calculated as the difference between observed mortality and expected mortality in 2020. We estimated that the number of excess deaths and the excess death rates due to prostate, breast, and uterus cancer were 610 deaths (55%; 12.8 deaths per 100,000 men), 443 deaths (43%; 6 deaths per 100,000 women), and 154 deaths (25%; 2 deaths per 100,000 women), respectively. Excess numbers of deaths and excess death rates due to prostate and breast cancer increased with age. These excess deaths were higher in men aged ≥ 80 years (596 deaths (64%) and 150 deaths per 100,000 men) and women aged 70-79 years (229 deaths (58%) and 15 deaths per 100,000 women), respectively. In summary, during the COVID-19 pandemic, there were excess prostate and breast cancer mortalities in 2020 in Peru, while excess uterus cancer mortalities were low. Age-stratified excess death rates for prostate cancer and breast cancer were higher in men ≥ 80 years and in women ≥ 70 years, respectively.
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Affiliation(s)
| | | | - Javier Vargas-Herrera
- Unidad de Telemedicina, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima 15001, Peru;
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21
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Lizambri D, Giacalone A, Shah PA, Tovani-Palone MR. Reconstruction surgery in head and neck cancer patients amidst the COVID-19 pandemic: Current practice and lessons for the future. World J Clin Cases 2023; 11:1434-1441. [PMID: 36926409 PMCID: PMC10011991 DOI: 10.12998/wjcc.v11.i7.1434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/20/2022] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has imposed a radical change in daily life and work routine. In this context, health systems have suffered important and serious repercussions in all fields. Among the changes brought about by the state of global health emergency, adjustments to guidelines, priorities, structures, professional teams, and epidemiological data stand out. In light of this, the oncological field has witnessed several changes in the approach to cancer, whether due to delay in diagnosis, screening deficit, personnel shortage or the psychological impact that the pandemic has had on cancer patients. This article focuses on the management of oral carcinoma and the surgical approaches that oral and maxillofacial specialists have had at their disposal during the health emergency. In this period, the oral and maxillofacial surgeons have faced many obstacles. The proximity of maxillofacial structures to the airways, the need of elective and punctual procedures in cancerous lesions, the aggressiveness of head and neck tumors, and the need for important healthcare costs to support such delicate surgeries are examples of some of the challenges imposed for this field. One of the possible surgical 'solutions' to the difficulties in managing surgical cases of oral carcinoma during the pandemic is locoregional flaps, which in the pre-COVID-19 era were less used than free flaps. However, during the health emergency, its use has been widely reassessed. This setback may represent a precedent for opening up new reflections. In the course of a long-term pandemic, a reassessment of the validity of different medical and surgical therapeutic approaches should be considered. Finally, given that the pandemic has high-lighted vulnerabilities and shortcomings in a number of ways, including the issues of essential resource shortages, underinvestment in public health services, lack of coordination and versatility among politicians, policymakers and health leaders, resulting in overloaded health systems, rapid case development, and high mortality, a more careful analysis of the changes needed in different health systems to satisfactorily face future emergencies is essential to be carried out. This should be directed especially towards improving the management of health systems, their coordination as well as reviewing related practices, even in the surgical field.
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Affiliation(s)
- Daniele Lizambri
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Caserta 81100, Italy
| | - Andrea Giacalone
- Department of Industrial Engineering, Technologies for Sports Medicine and Rehabilitation, University of Rome Tor Vergata, Rome 00133, Italy
| | - Pritik A Shah
- Bangalore Medical College and Research Institute, Karnataka 560002, India
| | - Marcos Roberto Tovani-Palone
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India
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22
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Exercise across the Lung Cancer Care Continuum: An Overview of Systematic Reviews. J Clin Med 2023; 12:jcm12051871. [PMID: 36902659 PMCID: PMC10003899 DOI: 10.3390/jcm12051871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Growing evidence supports exercise for people with lung cancer. This overview aimed to summarise exercise intervention efficacy and safety across the care continuum. METHODS Eight databases (including Cochrane and Medline) were searched (inception-February 2022) for systematic reviews of RCTs/quasi-RCTs. Eligibility: population-adults with lung cancer; intervention: exercise (e.g., aerobic, resistance) +/- non-exercise (e.g., nutrition); comparator: usual care/non-exercise; primary outcomes: exercise capacity, physical function, health-related quality of life (HRQoL) and post-operative complications. Duplicate, independent title/abstract and full-text screening, data extraction and quality ratings (AMSTAR-2) were completed. RESULTS Thirty systematic reviews involving between 157 and 2109 participants (n = 6440 total) were included. Most reviews (n = 28) involved surgical participants. Twenty-five reviews performed meta-analyses. The review quality was commonly rated critically low (n = 22) or low (n = 7). Reviews commonly included combinations of aerobic, resistance and/or respiratory exercise interventions. Pre-operative meta-analyses demonstrated that exercise reduces post-operative complications (n = 4/7) and improves exercise capacity (n = 6/6), whilst HRQoL findings were non-significant (n = 3/3). Post-operative meta-analyses reported significant improvements in exercise capacity (n = 2/3) and muscle strength (n = 1/1) and non-significant HRQoL changes (n = 8/10). Interventions delivered to mixed surgical and non-surgical populations improved exercise capacity (n = 3/4), muscle strength (n = 2/2) and HRQoL (n = 3). Meta-analyses of interventions in non-surgical populations demonstrated inconsistent findings. Adverse event rates were low, however, few reviews reported on safety. CONCLUSIONS A large body of evidence supports lung cancer exercise interventions to reduce complications and improve exercise capacity in pre- and post-operative populations. Additional higher-quality research is needed, particularly in the non-surgical population, including subgroup analyses of exercise type and setting.
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23
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Sex differences in drug effects and/or toxicity in oncology. CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2023; 4:100152. [PMID: 36714036 PMCID: PMC9881040 DOI: 10.1016/j.crphar.2022.100152] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 01/19/2023] Open
Abstract
The prevalence, incidence, and severity of a wide variety of diseases and ailments are significantly influenced by the significant disparities that occur between the sexes. The way that men and women react to pharmacological treatment also varies. Therefore, it is crucial to comprehend these reactions in order to conduct risk assessment correctly and to develop safe and efficient therapies. Even from that limited vantage point, the manner and timing of our drug usage might have unintended and unanticipated consequences. There are sex-specific differences in the incidence and mortality of certain malignancies. One of the most important discoveries in cancer epidemiology is the gender inequalities. Cancer incidence differences between the sexes are thought to be regulated at the genetic and molecular levels and by sex hormones like oestrogen. Differences based on sex and gender are among the least investigated factors impacting cancer susceptibility, progression, survival, and therapy response despite their established importance in clinical care. The molecular mechanisms underlying sex differences in particular are poorly known, hence the majority of precision medicine approaches employ mutational or other genetic data to assign therapy without taking into account how the patient's sex may affect therapeutic efficacy. In patients receiving chemotherapy, there are definite gender-dependent disparities in response rates and the likelihood of side effects. This review explores the influence of sex as a biological variable in drug effects or toxicity in oncology.
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24
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Lo Giudice G, Colella G, Boschetti CE, Colella C, Tartaro G, Cirillo N. Increased Delay in Diagnosis, but Not Treatment, Among Patients With Oral Cancer During the COVID-19 Pandemic. JAMA Otolaryngol Head Neck Surg 2023; 149:91-92. [PMID: 36394852 PMCID: PMC9673025 DOI: 10.1001/jamaoto.2022.3652] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This retrospective cohort study assesses delays in diagnosis and treatment for patients with oral squamous cell carcinoma in a tertiary care university hospital in Naples, Italy.
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Affiliation(s)
- Giorgio Lo Giudice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples “Federico II”, Naples, Italy
| | - Giuseppe Colella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ciro Emiliano Boschetti
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Chiara Colella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, Carton, Victoria, Australia
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25
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Cowling T, Nayakarathna R, Wills AL, Tankala D, Paul Roc N, Barakat S. Early access for innovative oncology medicines: a different story in each nation. J Med Econ 2023; 26:944-953. [PMID: 37466223 DOI: 10.1080/13696998.2023.2237336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/04/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND As innovative oncology medicines are rapidly developed, there is increasing pressure on payers to offer patients timely access to life-saving therapies. The uncertainty surrounding these therapies when phase III clinical trials are pending has necessitated new, adapted pathways to market access, with timelines that greatly vary by country. Understanding differences between pathways may identify opportunities to expedite patient access universally. OBJECTIVES To describe early access pathways for new oncology medicines among selected countries with established health technology assessment (HTA) frameworks and publicly funded health systems, with a special focus on real-world evidence (RWE). METHODS We reviewed the HTA agency websites of the selected OECD countries: National Institute for Health and Care Excellence (NICE) for England and Wales; Haute Autorité de Santé (HAS) for France; IQWiG and G-BA for Germany; Agenzia Italiana del Farmaco (AIFA) for Italy; Pharmaceutical Benefits Advisory Committee (PBAC) for Australia; and CADTH and Institut National d'Excellence en Santé et Services Sociaux (INESSS) for Canada as the primary source of evidence. RESULTS Processes for early patient access to innovative oncology therapies varied across selected countries; however, most countries have an established pathway for publicly funded early access (England and Wales, France, Germany, Italy, and Australia). The utilization of RWE to support earlier access (coverage with evidence) also varied by country, with some HTA organizations being actively engaged in these agreements (NICE, AIFA, and HAS) and others having no established processes in place (G-BA and CADTH/INESSS). CONCLUSIONS This review of early access pathways for novel oncology medicines found substantial variability between countries of interest. Coverage with evidence frameworks may provide a unique opportunity for industry and payers to collaborate on earlier access to innovative cancer therapies with life-saving potential.
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Affiliation(s)
- Tara Cowling
- Medlior Health Outcomes Research Ltd., Calgary, Canada
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26
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Lin T, Zhao Z, Yang Z, Li B, Wei C, Li F, Jiang Y, Liu D, Yang Z, Sha F, Tang J. Hospital Strain and COVID-19 Fatality - England, April 2020-March 2022. China CDC Wkly 2022; 4:1176-1180. [PMID: 36779170 PMCID: PMC9906047 DOI: 10.46234/ccdcw2022.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/14/2022] [Indexed: 02/14/2023] Open
Abstract
What is already known about this topic? During the coronavirus disease 2019 (COVID-19) pandemic, tremendous efforts have been made in countries to suppress epidemic peaks and strengthen hospital services to avoid hospital strain and ultimately reduce the risk of death from COVID-19. However, there is limited empirical evidence that hospital strain increases COVID-19 deaths. What is added by this report? We found the risk of death from COVID-19 was linearly associated with the number of patients currently in hospitals, a measure of hospital strain, before the Omicron period. This risk could be increased by a maximum of 188.0%. What are the implications for public health practice? These findings suggest that any (additional) effort to reduce hospital strain would be beneficial during early large COVID-19 outbreaks and possibly also others alike. During an Omicron outbreak, vigilance remains necessary to prevent excess deaths caused by hospital strain as happened in Hong Kong Special Administrative Region, China.
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Affiliation(s)
- Tengfei Lin
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen City, Guangdong Province, China
| | - Ziyi Zhao
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen City, Guangdong Province, China
| | - Zhirong Yang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen City, Guangdong Province, China
| | - Bingli Li
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen City, Guangdong Province, China
| | - Chang Wei
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen City, Guangdong Province, China
| | - Fuxiao Li
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen City, Guangdong Province, China
| | - Yiwen Jiang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen City, Guangdong Province, China
| | - Di Liu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen City, Guangdong Province, China
| | - Zuyao Yang
- Division of Epidemiology, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong Special Administrate Region, China,Zuyao Yang,
| | - Feng Sha
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen City, Guangdong Province, China,Feng Sha,
| | - Jinling Tang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen City, Guangdong Province, China,Department of Clinical Data Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou City, Guangdong Province, China
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27
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Nguyen PT, Saito E, Katanoda K. Long-Term Projections of Cancer Incidence and Mortality in Japan and Decomposition Analysis of Changes in Cancer Burden, 2020-2054: An Empirical Validation Approach. Cancers (Basel) 2022; 14:cancers14246076. [PMID: 36551562 PMCID: PMC9775633 DOI: 10.3390/cancers14246076] [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: 11/15/2022] [Revised: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The aim of this study was to project new cancer cases/deaths forward to 2054, and decompose changes in cancer cases/deaths to assess the impact of demographic transitions on cancer burden. METHODS We collected data on cancer cases/deaths up to 2019, empirically validated the projection performance of multiple statistical models, and selected optimal models by applying time series cross-validation. RESULTS We showed an increasing number of new cancer cases but decreasing number of cancer deaths in both genders, with a large burden attributed to population aging. We observed the increasing incidence rates in most cancer sites but reducing rates in some infection-associated cancers, including stomach and liver cancers. Colorectal and lung cancers were projected to remain as leading cancer burdens of both incidence and mortality in Japan over 2020-2054, while prostate and female breast cancers would be the leading incidence burdens among men and women, respectively. CONCLUSIONS Findings from decomposition analysis require more supportive interventions for reducing mortality and improving the quality of life of Japanese elders. We emphasize the important role of governments and policymakers in reforming policies for controlling cancer risk factors, including oncogenic infections. The rapid increase and continued presence of those cancer burdens associated with modifiable risk factors warrant greater efforts in cancer control programs, specifically in enhancing cancer screening and controlling cancer risk factors in Japan.
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Affiliation(s)
- Phuong The Nguyen
- Graduate School of Public Health, St. Luke’s International University, Tokyo 104-0045, Japan
- Division of Surveillance and Policy Evaluation, National Cancer Center Institute for Cancer Control, Tokyo 104-0045, Japan
- Correspondence: or
| | - Eiko Saito
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Kota Katanoda
- Division of Surveillance and Policy Evaluation, National Cancer Center Institute for Cancer Control, Tokyo 104-0045, Japan
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28
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Fu R, Sutradhar R, Dare A, Li Q, Hanna TP, Chan KKW, Irish JC, Coburn N, Hallet J, Singh S, Parmar A, Earle CC, Lapointe-Shaw L, Krzyzanowska MK, Finelli A, Louie AV, Witterick IJ, Mahar A, Urbach DR, McIsaac DI, Enepekides D, Look Hong NJ, Eskander A. Cancer Patients First Treated with Chemotherapy: Are They More Likely to Receive Surgery in the Pandemic? Curr Oncol 2022; 29:7732-7744. [PMID: 36290888 PMCID: PMC9600641 DOI: 10.3390/curroncol29100611] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
Due to the ramping down of cancer surgery in early pandemic, many newly diagnosed patients received other treatments first. We aimed to quantify the pandemic-related shift in rate of surgery following chemotherapy. This is a retrospective population-based cohort study involving adults diagnosed with cancer between 3 January 2016 and 7 November 2020 in Ontario, Canada who received chemotherapy as first treatment within 6-months of diagnosis. Competing-risks regression models with interaction effects were used to quantify the association between COVID-19 period (receiving a cancer diagnosis before or on/after 15 March 2020) and receipt of surgical reSection 9-months after first chemotherapy. Among 51,653 patients, 8.5% (n = 19,558) of them ultimately underwent surgery 9-months after chemotherapy initiation. Receipt of surgery was higher during the pandemic than before (sHR 1.07, 95% CI 1.02-1.13). Material deprivation was independently associated with lower receipt of surgery (least vs. most deprived quintile: sHR 1.11, 95% CI 1.04-1.17), but did not change with the pandemic. The surgical rate increase was most pronounced for breast cancer (sHR 1.13, 95% CI 1.06-1.20). These pandemic-related shifts in cancer treatment requires further evaluations to understand the long-term consequences. Persistent material deprivation-related inequity in cancer surgical access needs to be addressed.
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Affiliation(s)
- Rui Fu
- ICES, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada
| | - Rinku Sutradhar
- ICES, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - Anna Dare
- ICES, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
| | - Qing Li
- ICES, Toronto, ON M4N 3M5, Canada
| | - Timothy P. Hanna
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON K7L 3N6, Canada
- Ontario Institute for Cancer Research (OICR), Toronto, ON M5G 0A3, Canada
| | - Kelvin K. W. Chan
- Odette Cancer Centre—Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Ontario Health—Cancer Care Ontario, Toronto, ON M5G 2L7, Canada
| | - Jonathan C. Irish
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Otolaryngology—Head & Neck Surgery/Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON M5G 1X5, Canada
| | - Natalie Coburn
- ICES, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
- Ontario Health—Cancer Care Ontario, Toronto, ON M5G 2L7, Canada
| | - Julie Hallet
- ICES, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
- Odette Cancer Centre—Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
| | - Simron Singh
- ICES, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Ambica Parmar
- ICES, Toronto, ON M4N 3M5, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Craig C. Earle
- ICES, Toronto, ON M4N 3M5, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Lauren Lapointe-Shaw
- ICES, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Monika K. Krzyzanowska
- ICES, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Antonio Finelli
- ICES, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
| | - Alexander V. Louie
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada
| | - Ian J. Witterick
- Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada
- Odette Cancer Centre—Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Ontario Health—Cancer Care Ontario, Toronto, ON M5G 2L7, Canada
| | - Alyson Mahar
- School of Nursing, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - David R. Urbach
- ICES, Toronto, ON M4N 3M5, Canada
- Department of Surgery, Women’s College Hospital, Toronto, ON M5S 1B2, Canada
| | - Daniel I. McIsaac
- ICES, Toronto, ON M4N 3M5, Canada
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada
| | - Danny Enepekides
- Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada
| | - Nicole J. Look Hong
- ICES, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
| | - Antoine Eskander
- ICES, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada
- Correspondence: ; Tel.: +1-416-480-6705
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29
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Parray AM, Chaudhari VA, Bhandare MS, Madhabananda K, Muduly DK, Sudhindran S, Mathews J, Pradeep R, Thammineedi SR, Amal K, Chaudhary D, Jitender R, Pandey D, Amar P, Penumadu P, Kalayarasan R, Elamurugan TP, Kantharia C, Pujari S, Ramesh H, Somashekhar SP, Fernandes A, Sexena R, Singh RK, Lattoo MR, Shah OJ, Jeswanth S, Roy M, Thambudorai R, Shrikhande SV. Impact of Covid-19 on gastrointestinal cancer surgery: A National Survey. Langenbecks Arch Surg 2022; 407:3735-3745. [PMID: 36098808 PMCID: PMC9469820 DOI: 10.1007/s00423-022-02675-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/02/2022] [Indexed: 11/24/2022]
Abstract
Purpose To understand the actual impact of the Covid-19 pandemic and frame the future strategies, we conducted a pan India survey to study the impact on the surgical management of gastrointestinal cancers. Methods A national multicentre survey in the form of a questionnaire from 16 tertiary care gastrointestinal oncology centres across India was conducted from January 2019 to June 2021 that was divided into a 15-month pre-Covid era and a similar period of active Covid pandemic era. Results There was significant disruption of services; 13 (81%) centres worked as dedicated Covid care centres and 43% reported suspension of essential care for more than 6 months. In active Covid phase, there was a 14.5% decrease in registrations and proportion of decrease was highest in the centres from South zone (22%). There was decrease in resections across all organ systems; maximum reduction was noted in hepatic resections (33%) followed by oesophageal and gastric resections (31 and 25% respectively). There was minimal decrease in colorectal resections (5%). A total of 584 (7.1%) patients had either active Covid-19 infection or developed infection in the post-operative period or had recovered from Covid-19 infection. Only 3 (18%) centres reported higher morbidity, while the rest of the centres reported similar or lower morbidity rates when compared to pre-Covid phase; however, 6 (37%) centres reported slightly higher mortality in the active Covid phase. Conclusion
Covid-19 pandemic resulted in significant reduction in new cancer registrations and elective gastrointestinal cancer surgeries. Perioperative morbidity remained similar despite 7.1% perioperative Covid 19 exposure. Supplementary Information The online version contains supplementary material available at 10.1007/s00423-022-02675-6.
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Affiliation(s)
- Amir M Parray
- Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | | | | | - K Madhabananda
- All India Institute of Medical Sciences, Bhubaneshwar, India
| | - Dilip K Muduly
- All India Institute of Medical Sciences, Bhubaneshwar, India
| | - S Sudhindran
- Amrita Institute of Medical Sciences and Research Institute, Kochi, India
| | - Johns Mathews
- Amrita Institute of Medical Sciences and Research Institute, Kochi, India
| | - R Pradeep
- Asian Institute of Gastroenterology, Hyderabad, India
| | | | - K Amal
- Dr B Borooah Cancer Institute, Gauhati, India
| | | | - R Jitender
- Homi Bhabha Cancer Hospital (TMC), Sangrur, India
| | - Durgatosh Pandey
- Mahamana Pandit Madan Mohan Malaviya Cancer Centre & Homi Bhabha Cancer Hospital (TMC), Varanasi, India
| | - P Amar
- Mahamana Pandit Madan Mohan Malaviya Cancer Centre & Homi Bhabha Cancer Hospital (TMC), Varanasi, India
| | - Prasanth Penumadu
- Jawahar Lal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Raja Kalayarasan
- Jawahar Lal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - T P Elamurugan
- Jawahar Lal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | | | - H Ramesh
- Lakeshore Hospital and Research Centre, Kochi, India
| | | | | | - Rajan Sexena
- Sanjay Gandhi PGI of Medical Sciences, Lucknow, India
| | | | - Mohd R Lattoo
- Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Omar J Shah
- Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India
| | | | | | | | - Shailesh V Shrikhande
- Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India. .,Department of Gastrointestinal and Hepato-Pancreato-Biliary, Surgical Oncology, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, Maharashtra, 400012, India.
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30
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Duckett S. Public Health Management of the COVID-19 Pandemic in Australia: The Role of the Morrison Government. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10400. [PMID: 36012035 PMCID: PMC9407931 DOI: 10.3390/ijerph191610400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 05/24/2023]
Abstract
The Australian Commonwealth government has four health-related responsibilities during the SARS-CoV-2 pandemic: to provide national leadership; to manage external borders; to protect residents of residential aged care facilities; and to approve, procure and roll-out tests and vaccines. State governments are responsible for determining what public health measures are appropriate and implementing them-including managing the border quarantine arrangements and the testing, tracing, and isolation regime-and managing the hospital response. This paper analyses the national government's response to the pandemic and discusses why it has attracted a thesaurus of negative adjectives.
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Affiliation(s)
- Stephen Duckett
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
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31
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Luo Q, Steinberg J, Yu XQ, Weber M, Caruana M, Yap S, Grogan PB, Banks E, O'Connell DL, Canfell K. Projections of smoking-related cancer mortality in Australia to 2044. J Epidemiol Community Health 2022; 76:jech-2021-218252. [PMID: 35750482 PMCID: PMC9380484 DOI: 10.1136/jech-2021-218252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 06/12/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND While many high-income countries including Australia have successfully implemented a range of tobacco control policies, smoking remains the leading preventable cause of cancer death in Australia. We have projected Australian mortality rates for cancer types, which have been shown to have an established relationship with cigarette smoking and estimated numbers of cancer deaths attributable to smoking to 2044. METHODS Cancer types were grouped according to the proportion of cases currently caused by smoking: 8%-30% and >30%. For each group, an age-period- cohort model or generalised linear model with cigarette smoking exposure as a covariate was selected based on the model fit statistics and validation using observed data. The smoking-attributable fraction (SAF) was calculated for each smoking-related cancer using Australian smoking prevalence data and published relative risks. RESULTS Despite the decreasing mortality rates projected for the period 2015-2019 to 2040-2044 for both men and women, the overall number of smoking-related cancer deaths is estimated to increase by 28.7% for men and 35.8% for women: from 138 707 (77 839 men and 60 868 women) in 2015-2019 to 182 819 (100 153 men and 82 666 women) in 2040-2044. Over the period 2020-2044, there will be 254 583 cancer deaths (173 943 men and 80 640 women) directly attributable to smoking, with lung, larynx, oesophagus and oral (comprising lip, oral cavity and pharynx) cancers having the largest SAFs. INTERPRETATION Cigarette smoking will cause over 250 000 cancer deaths in Australia from 2020 to 2044. Continued efforts in tobacco control remain a public health priority, even in countries where smoking prevalence has substantially declined.
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Affiliation(s)
- Qingwei Luo
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Xue Qin Yu
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Marianne Weber
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Sarsha Yap
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Paul B Grogan
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Dianne L O'Connell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
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32
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Wells CR, Galvani AP. Impact of the COVID-19 pandemic on cancer incidence and mortality. THE LANCET PUBLIC HEALTH 2022; 7:e490-e491. [PMID: 35660207 PMCID: PMC9159732 DOI: 10.1016/s2468-2667(22)00111-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 01/11/2023] Open
Affiliation(s)
- Chad R Wells
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520, USA
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520, USA.
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