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Mignozzi S, Santucci C, Medina HN, Negri E, La Vecchia C, Pinheiro PS. Cancer mortality in Germany-born Americans and Germans. Cancer Epidemiol 2024; 88:102519. [PMID: 38183748 DOI: 10.1016/j.canep.2023.102519] [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: 10/05/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION Comparing cancer mortality and associated risk factors among immigrant populations in a host country to those in their country of origin reveals disparities in cancer risk, access to care, diagnosis, and disease management. This study compares cancer mortality between the German resident population and Germany-born individuals who migrated to the US. METHODS Cancer mortality data from 2008-2018 were derived for Germans from the World Health Organization database and for Germany-born Americans resident in four states (California, Florida, Massachusetts, and New York) from respective Departments of Vital Statistics. We calculated age-standardized mortality rates (ASMRs) using the European standard population and standardized mortality ratios (SMR) compared to the German resident population along with 95% confidence intervals (CIs). RESULTS Germany-born American males had lower ASMRs (253.8 per 100,000) than German resident population (325.6 per 100,000). The difference in females was modest, with ASMRs of 200.7 and 203.7 per 100,000, respectively. For all cancers, Germany-born American males had an SMR of 0.72 (95% CI: 0.70-0.74) and females 0.98 (95% CI: 0.95-1.00). Male SMRs among Germany-born Americans were significantly below one for oral cavity, stomach, colorectal, liver, lung, prostate, and kidney cancer. Among females, SMRs were below one for oral cavity, stomach, colorectal, gallbladder, breast, cervix uteri, and kidney cancer. For both sexes, SMRs were over one for bladder cancer (1.14 for males, 1.21 for females). Mortality was higher for lung cancer (SMR: 1.68), non-Hodgkin's lymphoma (1.18) and uterine cancer (1.22) among Germany-born American females compared to the German resident population. CONCLUSION Germany-born American males but not females showed lower cancer mortality than German resident population. Disparities may stem from variations in risk factors (e.g., smoking and alcohol use) as well as differences in screening practices and participation, cancer treatment, besides some residual potential "healthy immigrant effect".
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Affiliation(s)
- Silvia Mignozzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Claudia Santucci
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Heidy N Medina
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paulo S Pinheiro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
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Srilatha M, Malla R, Adem MP, Foote JB, Nagaraju GP. Obesity associated pancreatic ductal adenocarcinoma: Therapeutic challenges. Semin Cancer Biol 2023; 97:12-20. [PMID: 37926347 DOI: 10.1016/j.semcancer.2023.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 11/07/2023]
Abstract
Obesity is a prominent health issue worldwide and directly impacts pancreatic health, with obese individuals exhibiting a significant risk for increasing pancreatic ductal adenocarcinoma (PDAC). Several factors potentially explain the increased risk for the development of PDAC, including obesity-induced chronic inflammation within and outside of the pancreas, development of insulin resistance and metabolic dysfunction, promotion of immune suppression within the pancreas during inflammation, pre- and malignant stages, variations in hormones levels (adiponectin, ghrelin, and leptin) produced from the adipose tissue, and acquisition of somatic mutations in tumor once- and suppressor proteins critical for pancreatic tumorigenesis. In this manuscript, we will explore the broad impact of these obesity-induced risk factors on the development and progression of PDAC, focusing on changes within the tumor microenvironment (TME) as they pertain to prevention, current therapeutic strategies, and future directions for targeting obesity management as they relate to the prevention of pancreatic tumorigenesis.
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Affiliation(s)
- Mundla Srilatha
- Department of Biotechnology, Sri Venkateswara University, Tirupati, Andhra Pradesh 517502, India
| | - Ramarao Malla
- Cancer Biology Laboratory, Department of Biochemistry and Bioinformatics, School of Science, GITAM (Deemed to be University), Visakhapatnam, Andhra Pradesh 530045, India
| | - Megha Priya Adem
- Department of Biotechnology, Sri Padmavati Mahila Visvavidyalayam (Women's University), Tirupati, Andhra Pradesh 517502, India
| | - Jeremy B Foote
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
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Bedir A, Abera SF, Vordermark D, Medenwald D. Socioeconomic disparities in endometrial cancer survival in Germany: a survival analysis using population-based cancer registry data. J Cancer Res Clin Oncol 2022; 148:1087-1095. [PMID: 35064816 PMCID: PMC9015991 DOI: 10.1007/s00432-021-03908-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/27/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE Area-based socioeconomic deprivation has been established as an important indicator of health and a potential predictor of survival. In this study, we aimed to measure the effect of socioeconomic inequality on endometrial cancer survival. METHODS Population-based data on patients diagnosed with endometrial cancer between 2004 and 2014 were obtained from the German Centre for Cancer Registry Data. Socioeconomic inequality was defined by the German Index of Socioeconomic Deprivation. We investigated the association of deprivation and overall survival through Kaplan-Meier curves and Cox proportional regression models. RESULTS A total of 21,602 women, with a mean age of 67.8 years, were included in our analysis. The observed 5-year overall survival time for endometrial cancer patients living in the most affluent districts (first quintile) was 78.6%. The overall survival rate decreased as the level of deprivation increased (77.2%, 73.9%, 76.1%, 74.7%, for patients in the second, third, fourth, and fifth quintile (most deprived patients), respectively). Cox regression models showed stage I patients living in the most deprived districts to have a higher hazard of overall mortality when compared to the cases living in the most affluent districts [Hazard ratio: 1.20; 95% Confidence interval (0.99-1.47)] after adjusting for age, tumor characteristics, and treatment. CONCLUSION Our results indicate differences in endometrial cancer survival according to socioeconomic deprivation among stage I patients. Considering data limitations, future studies with access to individual-level patient information should be conducted to examine the underlying causes for the observed disparity in cancer survival.
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Affiliation(s)
- Ahmed Bedir
- Health Services Research Group, Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Semaw Ferede Abera
- Health Services Research Group, Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Dirk Vordermark
- Health Services Research Group, Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
- Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Daniel Medenwald
- Health Services Research Group, Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
- Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
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Unmet needs in the diagnosis and treatment of Romanian patients with bilio-pancreatic tumors: results of a prospective observational multicentric study. ACTA ACUST UNITED AC 2021; 59:286-295. [PMID: 33657285 DOI: 10.2478/rjim-2021-0009] [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: 12/12/2020] [Indexed: 11/20/2022]
Abstract
Background. Biliopancreatic tumors (BPT) are among the most aggressive solid malignancies, and their incidence is rising. Good patient outcome relies heavily on a multidisciplinary approach to therapy, including timely access to endoscopy, surgery and chemo/radiotherapy. We aimed to evaluate current practices as reflected in the management and outcome of patients diagnosed with BPT in the setting of a low-resource medical system in order to identify areas suitable for improvement. Material and methods. We conducted a prospective observational study of patients with pancreatic cancers and extrahepatic cholangiocarcinomas evaluated in 4 referral centers in Romania. We collected data on the pathology of the tumors, staging at diagnosis, ECOG status, surgical interventions, chemo/radiotherapy and endoscopic drainage where applicable. A telephonic follow-up visit at 3 months after the enrollment visit collected additional data regarding evolution, subsequent treatment, performance status and disease-related events and outcomes. Results and conclusions. One hundred seventy-two patients were included in the study during a one-year period at the four participating centers. 72.1% were diagnosed with pancreatic cancer while 27.9% had extrahepatic cholangiocarcinoma. We identified several unmet needs in the current practices of treatment for these malignancies: a lack of pathological confirmation in 25.6% of the cases, a very low percentage of resectable lesions (only 18% of the patients operated with curative intent), and suboptimal choice of drainage in patients who required palliative drainage at their first endoscopic intervention. Significant effort is required to ensure standard-of-care treatment for patient with BPT in low-resource medical systems, including comprehensive auditing and protocol surveillance.
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Bedir A, Abera SF, Efremov L, Hassan L, Vordermark D, Medenwald D. Socioeconomic disparities in head and neck cancer survival in Germany: a causal mediation analysis using population-based cancer registry data. J Cancer Res Clin Oncol 2021; 147:1325-1334. [PMID: 33569714 PMCID: PMC8021523 DOI: 10.1007/s00432-021-03537-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/15/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE Despite recent improvements in cancer treatment in Germany, a marked difference in cancer survival based on socioeconomic factors persists. We aim to quantify the effect of socioeconomic inequality on head and neck cancer (HNC) survival. METHODS Information on 20,821 HNC patients diagnosed in 2009-2013 was routinely collected by German population-based cancer registries. Socioeconomic inequality was defined by the German Index of Socioeconomic Deprivation. The Cox proportional regression and relative survival analysis measured the survival disparity according to level of socioeconomic deprivation with respective confidence intervals (CI). A causal mediation analysis was conducted to quantify the effect of socioeconomic deprivation mediated through medical care, stage at diagnosis, and treatment on HNC survival. RESULTS The most socioeconomically deprived patients were found to have the highest hazard of dying when compared to the most affluent (Hazard Ratio: 1.25, 95% CI 1.17-1.34). The most deprived patients also had the worst 5-year age-adjusted relative survival (50.8%, 95% CI 48.5-53.0). Our mediation analysis showed that most of the effect of deprivation on survival was mediated through differential stage at diagnosis during the first 6 months after HNC diagnosis. As follow-up time increased, medical care, stage at diagnosis, and treatment played no role in mediating the effect of deprivation on survival. CONCLUSION This study confirms the survival disparity between affluent and deprived HNC patients in Germany. Considering data limitations, our results suggest that, within six months after HNC diagnosis, the elimination of differences in stage at diagnosis could reduce survival inequalities.
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Affiliation(s)
- Ahmed Bedir
- Department of Radiation Oncology, Health Services Research Group, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Semaw Ferede Abera
- Department of Radiation Oncology, Health Services Research Group, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Ljupcho Efremov
- Department of Radiation Oncology, Health Services Research Group, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
- Institute of Medical Epidemiology, Biometry, and Informatics, Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06112, Halle (Saale), Germany
| | - Lamiaa Hassan
- Institute of Medical Epidemiology, Biometry, and Informatics, Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06112, Halle (Saale), Germany
| | - Dirk Vordermark
- Department of Radiation Oncology, Health Services Research Group, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
- Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Daniel Medenwald
- Department of Radiation Oncology, Health Services Research Group, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
- Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
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Grundmann N, Meisinger C, Trepel M, Müller-Nordhorn J, Schenkirsch G, Linseisen J. Trends in cancer incidence and survival in the Augsburg study region-results from the Augsburg cancer registry. BMJ Open 2020; 10:e036176. [PMID: 32868355 PMCID: PMC7462243 DOI: 10.1136/bmjopen-2019-036176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Knowledge about time trends of cancer incidence and cancer survival in a defined region is an essential prerequisite for the planning of regional healthcare infrastructure. The aim of the study was to provide population-based analyses of all common tumour sites to assess the cancer burden in the Augsburg study region. SETTING Total population of the study region of Augsburg (668 522 residents), Southern Germany. PARTICIPANTS The data obtained from the Cancer Registry Augsburg comprised 37 487 incident cases of malignant tumours (19 313 men and 18 174 women) diagnosed between 2005 and 2016 in the Augsburg region's resident population. PRIMARY AND SECONDARY OUTCOME MEASURES We calculated sex-specific, age-standardised incidence rates and annual percent change to assess time trends. In men and in women, 3-year and 5-year relative survival was calculated and results were compared with the latest German estimates. Survival trends were presented for the most common cancers only. RESULTS Decreasing age-standardised incidence rates were observed for prostate cancer and for colorectal cancer in men. For oropharyngeal cancer, rates declined in men, but significantly increased in women. Incidence for female breast cancer remained stable. Five-year relative survival ranged between 6.4% (95% CI: 4.1% to 10.1%) for pancreatic cancer and 97.7% (95% CI: 96.0% to 99.4%) for prostate cancer in men and between 10.2% (95% CI: 7.1% to 14.6%) for pancreatic cancer and 96.6% (95% CI: 93.6% to 99.6%) for malignant melanoma in women. Trends in 3-year survival of the five most common tumour sites in men showed a significant increase for lung and oropharyngeal cancer. In women, continuously rising survival trends were observed for breast cancer. CONCLUSIONS Survival of cancer patients in the Augsburg study region was largely concordant with the situation in Germany as a whole, while incidence showed slight deviations in some cancer sites. Regional evaluations on cancer survival are a valuable instrument for identifying deficits and determining advances in oncological health management.
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Affiliation(s)
- Nina Grundmann
- Chair of Epidemiology, Ludwig-Maximilians-Universität München at UNIKA-T, Augsburg, Germany
- IRG Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Christa Meisinger
- Chair of Epidemiology, Ludwig-Maximilians-Universität München at UNIKA-T, Augsburg, Germany
- IRG Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Martin Trepel
- Department of Internal Medicine II, University Medical Center of Augsburg, Augsburg, Germany
- Interdisciplinary Cancer Center, University Medical Center of Augsburg, Augsburg, Germany
| | | | - Gerhard Schenkirsch
- Interdisciplinary Cancer Center, University Medical Center of Augsburg, Augsburg, Germany
| | - Jakob Linseisen
- Chair of Epidemiology, Ludwig-Maximilians-Universität München at UNIKA-T, Augsburg, Germany
- IRG Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
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Sirri E, Kieschke J, Vohmann C, Katalinic A, Nennecke A, Ressing M, Eberle A, Holleczek B, Jansen L, Brenner H. Survival of malignant mesothelioma and other rare thoracic cancers in Germany and the United States: A population‐based study. Int J Cancer 2020; 147:1548-1558. [DOI: 10.1002/ijc.32931] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 12/19/2022]
Affiliation(s)
| | | | | | | | | | - Meike Ressing
- Cancer Registry of Rhineland‐Palatinate Mainz Germany
| | - Andrea Eberle
- Cancer Registry of Bremen, Leibniz Institute for Prevention Research and Epidemiology—BIPS Bremen Germany
| | | | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) Heidelberg Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), and National Center for Tumor Diseases (NCT) Heidelberg Germany
- German Cancer Consortium (DKTK), German Cancer Research Center Heidelberg Germany
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Jiang X, Wang L, Cheng Y, Tang H, Chen T. Assessment of long-term survival of cancer patients using cancer registry data from eastern China: Period analysis is superior to traditional methods. Int J Cancer 2020; 147:996-1005. [PMID: 31943167 DOI: 10.1002/ijc.32866] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/16/2019] [Accepted: 01/07/2020] [Indexed: 11/06/2022]
Abstract
We aimed to provide a systematical evaluation of the performance of period analysis compared to traditional cohort and complete methods, using cancer registry data from Taizhou, eastern China. Overall, 5-year relative survival (RS) estimate was calculated using cohort analysis, complete analysis and period analysis, respectively; further analyses were stratified by sex, region, age at diagnosis and cancer sites. Deviation value (DV), defined as the deviation between the estimated 5-year RS obtained from each method and the observed actual survival, was calculated to evaluate the accuracy of each method. Overall, 5-year RS derived by period analysis were much closer to the observed actual survival (51.4%), compared to those by complete and cohort methods, with the estimates of 48.7% (DV: -2.7%), 43.2% (DV: -8.2%) and 36.3% (DV: -15.1%), respectively. Further stratifications by sex, age at diagnosis, region and cancer sites also supported period analysis provided more precise estimates, compared to complete and cohort methods. We found, for first time systematically using cancer registry data from eastern China, period analysis provided more up-to-date precise estimates of long-term survival for overall and stratifications by sex, age at diagnosis, region and cancer sites, compared to traditional cohort and complete methods. Nevertheless, further investigations using large cancer registry data across China are warranted for the widespread use of period analysis in China.
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Affiliation(s)
- Xiyi Jiang
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Liangyou Wang
- Department of Non-communicable Chronic Disease Control and Prevention, Taizhou Center for Disease Control and Prevention, Taizhou, China
| | - Yongran Cheng
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Huijuan Tang
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Tianhui Chen
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences (CAS), Hangzhou, China.,Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Zhejiang Provincial Office for Cancer Prevention and Control, Hangzhou, China
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Schoffer O, Neumann A, Stabenow R, Schülein S, Böhm WD, Gonsior A, Horn LC, Kriegel C, Stolzenburg JU, Wirth M, Klug SJ. Penile cancer – Incidence, mortality, and survival in Saxony, Germany. Urol Oncol 2019; 37:295.e1-295.e8. [DOI: 10.1016/j.urolonc.2018.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 09/21/2018] [Accepted: 12/05/2018] [Indexed: 01/10/2023]
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Smith-Palmer J, Takizawa C, Valentine W. Literature review of the burden of prostate cancer in Germany, France, the United Kingdom and Canada. BMC Urol 2019; 19:19. [PMID: 30885200 PMCID: PMC6421711 DOI: 10.1186/s12894-019-0448-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 03/07/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Prostate cancer is the most frequently reported cancer in males in Europe, and is associated with substantial morbidity and mortality. The aim of the current review was to characterize the clinical, economic and humanistic burden of disease associated with prostate cancer in France, Germany, the UK and Canada. METHODS Literature searches were conducted using the PubMed, EMBASE and Cochrane Library databases to identify studies reporting incidence and/or mortality rates, costs and health state utilities associated with prostate cancer in the settings of interest. For inclusion, studies were required to be published in English in full-text form from 2006 onwards. RESULTS Incidence studies showed that in all settings the incidence of prostate cancer has increased substantially over the past two decades, driven in part by increased uptake of prostate specific antigen (PSA) screening leading to earlier identification of tumors, but which has also led to over-treatment, compounding the economic burden of disease. Mortality rates have declined over the same time frame, driven by earlier detection and improvements in treatment. Both prostate cancer itself, as well as treatment and treatment-related complications, are associated with reduced quality of life. CONCLUSIONS Prostate cancer is associated with a significant clinical and economic burden, whilst earlier detection and aggressive treatment is associated with improved survival, over-treatment of men with indolent tumors compounds the already significant burden of disease and treatment can lead to long-term side effects including impotence and impaired urinary and/or bowel function. There is currently an unmet clinical need for diagnostic and/or prognostic tools that facilitate personalized prostate cancer treatment, and potentially reduce the clinical, economic and humanistic burden of invasive cancer treatment.
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Affiliation(s)
- J. Smith-Palmer
- Ossian Health Economics and Communications GmbH, Bäumleingasse 20, 4051 Basel, Switzerland
| | - C. Takizawa
- Genomic Health International, Geneva, Switzerland
| | - W. Valentine
- Ossian Health Economics and Communications GmbH, Bäumleingasse 20, 4051 Basel, Switzerland
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Abstract
This article presents the current status of the implementation of clinical cancer registration across all German federal states that started in 2013 and that is basis for setting up comprehensive clinical and population-based cancer registries (CRs). A nationwide definition of relevant cancers, a common model of passive registration, a standard basic set of data items as well as a sustainable funding are prerequisites for a standardized collection of cancer data in Germany. For the collected information, the tools and methods used for data collection and processing, for statistical analyses and reporting, the potential synergies of a comprehensive CR implementing the tasks of both a clinical CR and a population-based CR become evident. Many different tasks of clinical and population-based CRs have already been implemented in Germany. This includes usage of individual patient data for quality assurance and the certification of cancer centers or comparative analyses on the adherence to guideline recommendations. CRs further provided unselected data on the cancer burden in the underlying populations and actively contribute in a variety of ways to many collaborative research projects on cancer etiology, the effectiveness of screening programs or cancer care, or provide patient or outcome data for clinical or population-based studies. Although many tasks of clinical and population-based CRs have already been implemented, a number of great efforts still lay ahead. Major challenges include the harmonization of data collection, the development of required standards and methods for data processing and usage, but first and foremost, the collection of complete and valid data for the different tasks of comprehensive CRs.
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Pulte D, Weberpals J, Schröder CC, Emrich K, Holleczek B, Katalinic A, Luttmann S, Sirri E, Jansen L, Brenner H. Survival of patients with hepatobiliary tract and duodenal cancer sites in Germany and the United States in the early 21st century. Int J Cancer 2018; 143:324-332. [DOI: 10.1002/ijc.31322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/24/2018] [Accepted: 02/05/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Dianne Pulte
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Janick Weberpals
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Chloé Charlotte Schröder
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Katharina Emrich
- Cancer Registry of Rhineland-Palatinate, Institute of Medical Biostatistics, Epidemiology, and Informatics; Mainz Germany
| | | | | | - Sabine Luttmann
- Bremen Cancer Registry, Leibniz-Institute for Prevention Research and Epidemiology - BIPS; Bremen Germany
| | - Eunice Sirri
- Cancer Registry of Lower Saxony; Oldenburg Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
- Division of Preventive Oncology; German Cancer Research Center (DKFZ); Heidelberg Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ); Heidelberg Germany
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Differences in incidence and survival of oral cavity and pharyngeal cancers between Germany and the United States depend on the HPV-association of the cancer site. Oral Oncol 2017; 76:8-15. [PMID: 29290288 DOI: 10.1016/j.oraloncology.2017.11.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 11/09/2017] [Accepted: 11/14/2017] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The epidemiology of squamous cell oral cavity and pharyngeal cancers (OCPC) has changed rapidly during the last years, possibly due to an increase of human papilloma virus (HPV) positive tumors and successes in tobacco prevention. Here, we compare incidence and survival of OCPC by HPV-relation of the site in Germany and the United States (US). MATERIALS AND METHODS Age-standardized and age-specific incidence and 5-year relative survival was estimated using data from population-based cancer registries in Germany and the US Surveillance Epidemiology and End Results (SEER) 13 database. Incidence was estimated for each year between 1999 and 2013. Relative survival for 2002-2005, 2006-2009, and 2010-2013 was estimated using period analysis. RESULTS The datasets included 52,787 and 48,861 cases with OCPC diagnosis between 1997 and 2013 in Germany and the US. Incidence was much higher in Germany compared to the US for HPV-unrelated OCPC and more recently also for HPV-related OCPC in women. Five-year relative survival differences between Germany and the US were small for HPV-unrelated OCPC. For HPV-related OCPC, men had higher survival in the US (62.1%) than in Germany (45.4%) in 2010-2013. These differences increased over time and were largest in younger patients and stage IV disease without metastasis. In contrast, women had comparable survival for HPV-related OCPC in both countries. CONCLUSIONS Strong survival differences between Germany and the US were observed for HPV-related OCPC in men, which might be explained by differences in HPV-attributable proportions. Close monitoring of the epidemiology of OCPC in each country is needed.
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Hammersen F, Lewin P, Gebauer J, Kreitschmann-Andermahr I, Brabant G, Katalinic A, Waldmann A. Sleep quality and health-related quality of life among long-term survivors of (non-) Hodgkin lymphoma in Germany. PLoS One 2017; 12:e0187673. [PMID: 29107959 PMCID: PMC5673196 DOI: 10.1371/journal.pone.0187673] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/24/2017] [Indexed: 12/12/2022] Open
Abstract
This study investigated sleep quality and health-related quality of life (HRQOL) among long-term survivors of Hodgkin (HL) and non-Hodgkin lymphoma (NHL). The aim was to explore the impact of personal and health-related factors on sleep quality as well as associations between sleep quality and HRQOL. For the postal survey, participants with a minimum age of 18 years initially treated between 1998 and 2008 were recruited via the population-based cancer registry in Schleswig-Holstein, Northern Germany. Questionnaires included amongst others the Pittsburg Sleep Quality Index (PSQI) and the 36-Item Short Form Health Survey (SF-36v1). Descriptive and comparative statistics were performed. Additionally, a regression analysis was conducted to identify predictors of sleep quality. In total, we recruited 515 participants (398 NHL, 117 HL) with a mean age of 63.1 years. Approximately half of the survivors were classified as good sleepers. HRQOL scores differed between good and poor sleepers with lower scores in poor sleepers. In a prediction model, self-reported depression, exhaustion, higher age, inability to work, endocrinological disorders and female gender classified as predictors of sleep quality. This study highlights the impact of sleep quality on HRQOL in long-term survivors of NHL and HL. Thus, sleep quality should be routinely assessed during follow-up of cancer survivors with special attention to patients with potential risk factors.
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Affiliation(s)
- Friederike Hammersen
- Institute for Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
- * E-mail:
| | - Philip Lewin
- Institute for Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Judith Gebauer
- Experimental and Clinical Endocrinology Department of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
| | | | - Georg Brabant
- Experimental and Clinical Endocrinology Department of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
| | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
- Institute for Cancer Epidemiology e.V., University of Luebeck, Luebeck, Germany
| | - Annika Waldmann
- Institute for Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
- Hamburg Cancer Registry, Hamburg, Germany
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16
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Pulte D, Weberpals J, Jansen L, Luttmann S, Holleczek B, Nennecke A, Ressing M, Katalinic A, Brenner H, Geiss K, Meyer M, Eberle A, Luttmann S, Stabenow R, Hentschel S, Nennecke A, Kieschke J, Sirri E, Holleczek B, Emrich K, Kajüter H, Mattauch V, Katalinic A, Eisemann N, Barnes B, Kraywinkel K, Brenner H, Jansen L, Weberpals J. Survival for patients with rare haematologic malignancies: Changes in the early 21st century. Eur J Cancer 2017; 84:81-87. [DOI: 10.1016/j.ejca.2017.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 07/06/2017] [Accepted: 07/11/2017] [Indexed: 11/15/2022]
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17
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Chen T, Brenner H, Fallah M, Jansen L, Castro FA, Geiss K, Holleczek B, Katalinic A, Luttmann S, Sundquist K, Ressing M, Xu L, Hemminki K. Risk of second primary cancers in women diagnosed with endometrial cancer in German and Swedish cancer registries. Int J Cancer 2017; 141:2270-2280. [PMID: 28815572 DOI: 10.1002/ijc.30930] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/19/2017] [Accepted: 07/31/2017] [Indexed: 11/10/2022]
Abstract
Along with the increasing incidence and favorable prognosis, more women diagnosed with endometrial cancer may develop second primary cancers (SPCs). We aimed at investigating risk of SPCs after endometrial cancer in Germany and Sweden to provide insight into prevention strategies for SPCs. Endometrial cancer patients diagnosed at age ≥15 years in Germany during 1997-2011 and in Sweden nationwide during 1997-2012 were selected. Standardized incidence ratios (SIRs), calculated as the ratio of observed to expected numbers of cases, were used to assess the risk of a specific second cancer after endometrial cancer for both German and Swedish datasets. Among 46,929 endometrial cancer survivors in Germany and 18,646 in Sweden, overall 2,897 and 1,706 SPCs were recorded, respectively. Significantly elevated SIRs were observed in Germany for ovarian (SIR = 1.3; 95%CI:1.1-1.5) and kidney cancers [1.6 (1.3-1.8)], while in Sweden the SIRs were 5.4 (4.6-6.3) and1.4 (1.0-1.9), respectively. Elevated risk for second ovarian endometrioid carcinoma was pronounced after early (<55 years) onset endometrial cancer in Germany [9.0 (4.8-15)] and Sweden [7.7 (5.1-11)]. In Germany elevated risks were found for second ovarian endometrioid carcinoma after endometrioid histology of first endometrial cancer [6.3 (4.0-9.4)] and for second kidney cancer after clear cell histology of endometrial cancer [4.9 (1.6-11)]. We found exceptionally elevated risk of second ovarian endometrioid carcinoma after endometrial cancer of the same histology or of early onset. Risk for second kidney cancer was also increased, particularly after endometrial cancer of clear cell histology. Cancer prevention strategies should focus on these cancers after endometrial cancer diagnosis.
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Affiliation(s)
- Tianhui Chen
- Group of Molecular Epidemiology and Cancer Precision Prevention (GMECPP), Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences (ZJAMS), Hangzhou, China.,Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Ningbo University Medical School, Ningbo, China
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mahdi Fallah
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Felipe A Castro
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Karla Geiss
- Bavarian Health and Food Safety Authority, Centre of Early Cancer Detection and Cancer Registration, Nürnberg, Germany
| | | | | | - Sabine Luttmann
- Cancer Registry of Bremen, Leibniz-Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden.,Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA
| | - Meike Ressing
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Germany.,Cancer Registry Rhineland-Palatinate, Mainz, Germany
| | - Leiting Xu
- Ningbo University Medical School, Ningbo, China
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, Malmö, Sweden
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18
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Wollina U, Rilke C, Hansel G, Langer D, Schönlebe J, Tchernev G. Interdigital Melanoma of the Foot Affecting Two Neighbouring Interdigital Spaces - Second Case Report. Open Access Maced J Med Sci 2017; 5:448-450. [PMID: 28785329 PMCID: PMC5535654 DOI: 10.3889/oamjms.2017.112] [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: 04/27/2017] [Revised: 05/11/2017] [Accepted: 05/19/2017] [Indexed: 11/22/2022] Open
Abstract
Melanoma affecting two interdigital spaces has been recently described by our group for the first time in medical literature. Here we present a second patient with acrolentiginous melanoma of the sole affecting the 1st and 2nd interdigital space. The tumour was removed by delayed Mohs surgery. Due to the extension of the melanoma, digit II and III had to be removed. Staging excluded metastatic spread. The tumour was classified as pT4bN0M0.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt in Dresden, Dresden, Germany
| | - Carsten Rilke
- Department for Vascular Surgery, Endovascular Surgery, Phlebology, Dresden, Sachsen, Germany
| | - Gesina Hansel
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt in Dresden, Dresden, Germany
| | - Dana Langer
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt in Dresden, Dresden, Germany
| | - Jacqueline Schönlebe
- Institute of Pathology "Georg Schmorl", Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany
| | - Georgi Tchernev
- Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, and Onkoderma Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
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19
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Weberpals J, Pulte D, Jansen L, Luttmann S, Holleczek B, Nennecke A, Ressing M, Katalinic A, Merz M, Brenner H. Survival of patients with lymphoplasmacytic lymphoma and solitary plasmacytoma in Germany and the United States of America in the early 21 st century. Haematologica 2017; 102:e229-e232. [PMID: 28280077 PMCID: PMC5451350 DOI: 10.3324/haematol.2016.157768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Janick Weberpals
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dianne Pulte
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sabine Luttmann
- Bremen Cancer Registry, Leibniz-Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | | | - Alice Nennecke
- Hamburg Cancer Registry, Authority for Health and Consumer Protection, Hamburg, Germany
| | - Meike Ressing
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
- Cancer Registry Rhineland-Palatinate, Mainz, Germany
| | | | - Maximilian Merz
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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20
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Ose D, Winkler EC, Berger S, Baudendistel I, Kamradt M, Eckrich F, Szecsenyi J. Complexity of care and strategies of self-management in patients with colorectal cancer. Patient Prefer Adherence 2017; 11:731-742. [PMID: 28435231 PMCID: PMC5391842 DOI: 10.2147/ppa.s127612] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Given the inherent complexity of cancer care, in which personal, social, and clinical aspects accumulate and interact over time, self-management support need to become more comprehensive. This study has the following two aims: 1) to analyze and describe the complexity of individual patient situations and 2) to analyze and describe already established self-management strategies of patients to handle this complexity. METHODS A qualitative study was conducted. Ten focus groups were performed collecting perspectives of the following three user groups: patients with colorectal cancer (n=12) and representatives from support groups (n=2), physicians (n=17), and other health care professionals (HCPs; n=16). Data were analyzed using qualitative content analysis. RESULTS The results showed that cancer patients are struggling with the complexity of their individual situations characterized by the 1) "complexity of disease", 2) "complexity of care", and 3) "complexity of treatment-related data". To deal with these multifaceted situations, patients have established several individual strategies. These strategies are "proactive demanding" (eg, to get support and guidance or a meaningful dialog with the doctor), "proactive behavior" (eg, preparation of visits), and "proactive data management" (eg, in terms of merging treatment-related data and to disseminate these to their health care providers). CONCLUSION Patients with colorectal cancer have to handle a high complexity of individual situations within treatment and care of their disease. Private and social challenges have a culminating effect. This complexity increases as patients experience a longer duration of treatment and follow-up as patients have to handle a significantly higher amount of data over time. Self-management support should focus more on the individual complexity in a patient's life. This includes assisting patients with strategies that have already been established by themselves (like preparation of visits).
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Affiliation(s)
- Dominik Ose
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
- Department of Population Health, Health System Innovation and Research, University of Utah, Salt Lake City, UT, USA
- Correspondence: Dominik Ose, University of Utah, Department of Population Health Sciences, Health System Innovation and Research, Williams Building, 295 Chipeta Way, Salt Lake City, UT 84108, USA, Tel +1 801 587 2263, Fax +1 801 581 3623, Email
| | - Eva C Winkler
- Program for Ethics and Patient-oriented Care in Oncology, National Centre for Tumour Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Sarah Berger
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Ines Baudendistel
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Martina Kamradt
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Felicitas Eckrich
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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21
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Schoffer O, Schülein S, Arand G, Arnholdt H, Baaske D, Bargou RC, Becker N, Beckmann MW, Bodack Y, Böhme B, Bozkurt T, Breitsprecher R, Buchali A, Burger E, Burger U, Dommisch K, Elsner G, Fernschild K, Flintzer U, Funke U, Gerken M, Göbel H, Grobe N, Gumpp V, Heinzerling L, Kempfer LR, Kiani A, Klinkhammer-Schalke M, Klöcking S, Kreibich U, Knabner K, Kuhn P, Lutze S, Mäder U, Maisel T, Maschke J, Middeke M, Neubauer A, Niedostatek A, Opazo-Saez A, Peters C, Schell B, Schenkirsch G, Schmalenberg H, Schmidt P, Schneider C, Schubotz B, Seide A, Strecker P, Taubenheim S, Wackes M, Weiß S, Welke C, Werner C, Wittekind C, Wulff J, Zettl H, Klug SJ. Tumour stage distribution and survival of malignant melanoma in Germany 2002-2011. BMC Cancer 2016; 16:936. [PMID: 27919243 PMCID: PMC5139127 DOI: 10.1186/s12885-016-2963-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 11/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Over the past two decades, there has been a rising trend in malignant melanoma incidence worldwide. In 2008, Germany introduced a nationwide skin cancer screening program starting at age 35. The aims of this study were to analyse the distribution of malignant melanoma tumour stages over time, as well as demographic and regional differences in stage distribution and survival of melanoma patients. METHODS Pooled data from 61 895 malignant melanoma patients diagnosed between 2002 and 2011 and documented in 28 German population-based and hospital-based clinical cancer registries were analysed using descriptive methods, joinpoint regression, logistic regression and relative survival. RESULTS The number of annually documented cases increased by 53.2% between 2002 (N = 4 779) and 2011 (N = 7 320). There was a statistically significant continuous positive trend in the proportion of stage UICC I cases diagnosed between 2002 and 2011, compared to a negative trend for stage UICC II. No trends were found for stages UICC III and IV respectively. Age (OR 0.97, 95% CI 0.97-0.97), sex (OR 1.18, 95% CI 1.11-1.25), date of diagnosis (OR 1.05, 95% CI 1.04-1.06), 'diagnosis during screening' (OR 3.24, 95% CI 2.50-4.19) and place of residence (OR 1.23, 95% CI 1.16-1.30) had a statistically significant influence on the tumour stage at diagnosis. The overall 5-year relative survival for invasive cases was 83.4% (95% CI 82.8-83.9%). CONCLUSIONS No distinct changes in the distribution of malignant melanoma tumour stages among those aged 35 and older were seen that could be directly attributed to the introduction of skin cancer screening in 2008.
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Affiliation(s)
- Olaf Schoffer
- Cancer Epidemiology, University Cancer Center, Technische Universität Dresden, Dresden, Germany. .,Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, Georg-Brauchle-Ring 56, 80992, Munich, Germany.
| | - Stefanie Schülein
- Cancer Epidemiology, University Cancer Center, Technische Universität Dresden, Dresden, Germany.,Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, Georg-Brauchle-Ring 56, 80992, Munich, Germany
| | - Gerlinde Arand
- Onkologischer Schwerpunkt (OSP) Göppingen, Göppingen, Germany
| | | | | | | | - Nikolaus Becker
- National Centre for Tumour Diseases (NCT) Heidelberg, Heidelberg, Germany
| | | | - Yves Bodack
- Onkologische Qualitätssicherung (QS) in Westfalen-Lippe, Münster, Germany
| | - Beatrix Böhme
- Regional Clinical Cancer Registry Magdeburg, Magdeburg, Germany
| | | | | | - Andre Buchali
- Tumour Centre Brandenburg, Frankfurt (Oder), Germany
| | - Elke Burger
- Regional Clinical Cancer Registry Magdeburg, Magdeburg, Germany
| | | | | | - Gudrun Elsner
- Onkologischer Schwerpunkt (OSP) Göppingen, Göppingen, Germany
| | | | | | | | | | | | - Norbert Grobe
- Tumour Centre Neubrandenburg, Neubrandenburg, Germany
| | - Vera Gumpp
- Tumour Centre Freiburg/Comprehensive Cancer Centre Freiburg (CCCF), Freiburg im Breisgau, Germany
| | | | | | | | | | | | - Ute Kreibich
- Cancer Register of Southwest Saxony, Zwickau, Zwickau, Germany
| | | | - Peter Kuhn
- Tumour Centre Ulm/Comprehensive Cancer Centre Ulm (CCCU), Ulm, Germany
| | - Stine Lutze
- Tumour Centre Vorpommern, Greifswald, Germany
| | - Uwe Mäder
- Tumour Centre Würzburg, Würzburg, Germany
| | | | - Jan Maschke
- Tumour Centre Görlitz, Görlitz, Germany.,Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Martin Middeke
- Comprehensive Cancer Centre (CCC) Marburg, Marburg, Germany
| | | | | | | | - Christoph Peters
- Tumour Centre Freiburg/Comprehensive Cancer Centre Freiburg (CCCF), Freiburg im Breisgau, Germany
| | | | | | | | | | | | | | | | | | | | | | | | - Claudia Welke
- Tumour Centre Ulm/Comprehensive Cancer Centre Ulm (CCCU), Ulm, Germany
| | - Carmen Werner
- Regional Clinical Cancer Registry Dresden, Dresden, Germany
| | | | - Jörg Wulff
- Cancer Register of Southwest Saxony, Zwickau, Zwickau, Germany
| | | | - Stefanie J Klug
- Cancer Epidemiology, University Cancer Center, Technische Universität Dresden, Dresden, Germany.,Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, Georg-Brauchle-Ring 56, 80992, Munich, Germany
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22
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Ilic M, Ilic I. Epidemiology of pancreatic cancer. World J Gastroenterol 2016; 22:9694-9705. [PMID: 27956793 PMCID: PMC5124974 DOI: 10.3748/wjg.v22.i44.9694] [Citation(s) in RCA: 885] [Impact Index Per Article: 110.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 08/30/2016] [Accepted: 09/28/2016] [Indexed: 02/06/2023] Open
Abstract
Cancer of the pancreas remains one of the deadliest cancer types. Based on the GLOBOCAN 2012 estimates, pancreatic cancer causes more than 331000 deaths per year, ranking as the seventh leading cause of cancer death in both sexes together. Globally, about 338000 people had pancreatic cancer in 2012, making it the 11th most common cancer. The highest incidence and mortality rates of pancreatic cancer are found in developed countries. Trends for pancreatic cancer incidence and mortality varied considerably in the world. A known cause of pancreatic cancer is tobacco smoking. This risk factor is likely to explain some of the international variations and gender differences. The overall five-year survival rate is about 6% (ranges from 2% to 9%), but this vary very small between developed and developing countries. To date, the causes of pancreatic cancer are still insufficiently known, although certain risk factors have been identified, such as smoking, obesity, genetics, diabetes, diet, inactivity. There are no current screening recommendations for pancreatic cancer, so primary prevention is of utmost importance. A better understanding of the etiology and identifying the risk factors is essential for the primary prevention of this disease.
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23
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Axtner J, Steele M, Kröz M, Spahn G, Matthes H, Schad F. Health services research of integrative oncology in palliative care of patients with advanced pancreatic cancer. BMC Cancer 2016; 16:579. [PMID: 27485618 PMCID: PMC4971628 DOI: 10.1186/s12885-016-2594-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 07/21/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Pancreatic cancer has a dire prognosis and is associated with a high mortality. Palliative patients have special needs and often seek help in integrative oncological concepts (IO) that combine conventional and complementary therapies. Nevertheless there are few recommendations regarding IO in current cancer guidelines. The aims of this study were to report on implementation of IO in everyday palliative care and to analyze patient survival in advanced pancreatic cancer. METHODS This multicenter observational study investigates the implementation of IO and length of survival of patients suffering from advanced pancreatic cancer (stage IV). We analyzed patient's survival by employing multivariable proportional hazard models using different parametric distribution functions and compared patients receiving chemotherapy only, a combination of chemotherapy and Viscum album (VA) treatment, and VA treatment only. RESULTS Records of 240 patients were analyzed. Complementary therapy showed high acceptance (93 %). Most frequent therapy was VA treatment (74 %) that was often administered concomitantly to chemotherapy (64 %). Both therapies had positive effects on patient survival as they had significant negative effects on the hazard in our log-normal model. A second analysis showed that patients with combined chemotherapy and VA therapy performed significantly better than patients receiving only chemotherapy (12.1 to 7.3 month). Patients receiving only VA therapy showed longer survival than those receiving neither chemotherapy nor VA therapy (5.4 to 2.5 months). Our data demonstrates that IO can be implemented in the everyday care of patients without disregarding conventional treatment. Patients combining VA with chemotherapy showed longest survival. CONCLUSIONS Our data demonstrate the importance and potential of health services research showing that IO treatment can be successfully implemented in the every-day care of patients suffering from advanced pancreatic cancer. Patients combining VA with chemotherapy showed longest survival. To address patients' needs adequately, future cancer guidelines might increasingly include comments on complementary treatment options in addition to conventional therapies. Further studies should investigate the effect of complementary treatments on survival and quality of life in more detail.
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Affiliation(s)
- Jan Axtner
- Forschungsinstitut Havelhöhe gGmbH, Kladower Damm 221, 14089, Berlin, Germany
| | - Megan Steele
- Forschungsinstitut Havelhöhe gGmbH, Kladower Damm 221, 14089, Berlin, Germany.,ihop Research Group, Queensland University of Technology, School of Public Health and Social Work, Victoria Park Road, 4059, Brisbane, Australia
| | - Matthias Kröz
- Forschungsinstitut Havelhöhe gGmbH, Kladower Damm 221, 14089, Berlin, Germany.,Krankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany
| | - Günther Spahn
- Institut für Integrative Krebstherapie, Hans-Böckler-Str. 7, 55128, Mainz, Germany
| | - Harald Matthes
- Forschungsinstitut Havelhöhe gGmbH, Kladower Damm 221, 14089, Berlin, Germany.,Krankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany
| | - Friedemann Schad
- Forschungsinstitut Havelhöhe gGmbH, Kladower Damm 221, 14089, Berlin, Germany. .,Krankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany.
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24
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Abstract
OBJECTIVES Survival improvement for pancreatic cancer has not been observed in the last 4 decades. We report the most up-to-date population-based relative survival (RS) estimates and recent trends in Germany and the United States. METHODS Data for patients diagnosed in 1997 to 2010 and followed up to 2010 were drawn from 12 population-based German cancer registries and the US SEER (Surveillance, Epidemiology and End Results) 13 registries database. Using period analysis, 5-year RS for 2007 to 2010 was derived. Model-based period analysis was used to assess 5-year RS time trends, 2002-2010. RESULTS In total 28,977 (Germany) and 34,793 (United States) patients aged 15 to 74 years were analyzed. Five-year RS was 10.7% and 10.3% in Germany and the United States, respectively, and strongly decreased with age and tumor spread. Prognosis slightly improved from the period 2002-2004 to 2008-2010 (overall age-adjusted RS: +2.5% units in Germany and +3.4% units in the United States); improvement was particularly strong for regional stage and head and body subsites in Germany and for localized and regional stages and tail subsite in the United States. CONCLUSIONS Although pancreatic cancer survival continues to be poor for advanced-stage patients, our study disclosed encouraging indications of first improvements in 5-year RS after decades of stagnation.
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25
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Pulte D, Jansen L, Castro FA, Krilaviciute A, Katalinic A, Barnes B, Ressing M, Holleczek B, Luttmann S, Brenner H. Survival in patients with acute myeloblastic leukemia in Germany and the United States: Major differences in survival in young adults. Int J Cancer 2016; 139:1289-96. [DOI: 10.1002/ijc.30186] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/20/2016] [Accepted: 04/29/2016] [Indexed: 01/19/2023]
Affiliation(s)
- Dianne Pulte
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Felipe A. Castro
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Agne Krilaviciute
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
| | | | - Benjamin Barnes
- National Center for Cancer Registry Data, Robert Koch Institute; Berlin Germany
| | - Meike Ressing
- Institute of Medical Biostatistics, Epidemiology and Informatics; University Medical Centre, Mainz, Germany, Johannes Gutenberg University; Mainz
- Cancer Registry Rhineland-Palatinate; Mainz Germany
| | | | - Sabine Luttmann
- Bremen Cancer Registry, Leibniz-Institute for Prevention Research and Epidemiology-BIPS; Bremen Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
- Division of Preventive Oncology; German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT); Heidelberg Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ); Heidelberg Germany
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Carrato A, Falcone A, Ducreux M, Valle JW, Parnaby A, Djazouli K, Alnwick-Allu K, Hutchings A, Palaska C, Parthenaki I. A Systematic Review of the Burden of Pancreatic Cancer in Europe: Real-World Impact on Survival, Quality of Life and Costs. J Gastrointest Cancer 2016; 46:201-11. [PMID: 25972062 PMCID: PMC4519613 DOI: 10.1007/s12029-015-9724-1] [Citation(s) in RCA: 181] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE The purpose of this study was to assess the overall burden of pancreatic cancer in Europe, with a focus on survival time in a real-world setting, and the overall healthy life lost to the disease. METHODS Real-world data were retrieved from peer-reviewed, observational studies identified by an electronic search. We performed two de novo analyses: a proportional shortfall analysis to quantify the proportion of healthy life lost to pancreatic cancer and an estimation of the aggregate life-years lost annually in Europe. RESULTS Ninety-one studies were included. The median, age-standardised incidence of pancreatic cancer per 100,000 was 7.6 in men and 4.9 in women. Overall median survival from diagnosis was 4.6 months; median survival was 2.8-5.7 months in patients with metastatic disease. The proportional shortfall analysis showed that pancreatic cancer results in a 98 % loss of healthy life, with a life expectancy at diagnosis of 4.6 months compared to 15.1 years for an age-matched healthy population. Annually, 610,000-915,000 quality-adjusted life-years (QALYs) are lost to pancreatic cancer in Europe. Patients had significantly lower scores on validated health-related quality of life instruments versus population norms. CONCLUSIONS To the best of our knowledge, this is the first study to systematically review real-world overall survival and patient outcomes of pancreatic cancer patients in Europe outside the context of clinical trials. Our findings confirm the poor prognosis and short survival reported by national studies. Pancreatic cancer is a substantial burden in Europe, with nearly a million aggregate life-years lost annually and almost complete loss of healthy life in affected individuals.
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Affiliation(s)
- A. Carrato
- />Medical Oncology Department, Ramon y Cajal University Hospital, Ctra. Colmenar Viejo Km. 9,100, Madrid, Spain
| | - A. Falcone
- />Unit of Medical Oncology, Pisa University Hospital, Via Roma 67, Pisa, 56126 Italy
| | - M. Ducreux
- />Gastrointestinal Unit, Gustave Roussy Institute, 114 Rue Edouard-Vaillant, 94805 Villejuif, France
| | - J. W. Valle
- />Department of Medical Oncology, University of Manchester and Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX UK
| | - A. Parnaby
- />Celgene Corporation, Route de Perreux 1, 2017 Boudry, Switzerland
| | - K. Djazouli
- />Celgene Corporation, Route de Perreux 1, 2017 Boudry, Switzerland
| | | | - A. Hutchings
- />Dolon Ltd, 175-185 Grays Inn Road, London, WC1X 8UE UK
| | - C. Palaska
- />Dolon Ltd, 175-185 Grays Inn Road, London, WC1X 8UE UK
| | - I. Parthenaki
- />Dolon Ltd, 175-185 Grays Inn Road, London, WC1X 8UE UK
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Hughes DL, Neal RD, Lyratzopoulos G, Rubin G. Profiling for primary-care presentation, investigation and referral for liver cancers: evidence from a national audit. Eur J Gastroenterol Hepatol 2016; 28:428-32. [PMID: 26684694 DOI: 10.1097/meg.0000000000000555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND AIM The incidence of liver cancer across Europe is increasing. There is a lack of evidence within the current literature on the identification and investigation of liver cancer within primary care. We aimed to profile liver cancer recognition and assessment as well as the timeliness of liver cancer diagnosis from within the primary-care setting in the UK. METHODS Data were obtained from the National Audit of Cancer Diagnosis in Primary Care 2009-2010 and analysed. We calculated the patient interval, the primary-care interval and the number of prereferral consultations for liver cancer. We then compared these data with prior data on the respective indicators for other common cancers. RESULTS The median patient interval was 9 days (interquartile range 0-31 days), and the median primary-care interval for liver cancer was 11 days (interquartile range 0-40 days). Of the 90 patients, 21 (23.3%) had three or more consultations with their general practitioner before specialist referral. For the three metrics (patient interval, primary-care interval and number of prereferral consultations), liver cancer has average or longer intervals when compared with other cancers. The most common symptomatic presentation of liver cancer within the primary-care setting was right upper quadrant pain (11%), followed by decompensated liver failure (9%). Of the patients, 12% were diagnosed with liver cancer on the basis of an incidental finding of an abnormal liver function test. CONCLUSION This study provides a detailed and thorough overview of the recognition of liver cancer and the promptness of liver cancer identification in an English context, and should inform strategies for improving the timeliness of diagnosis.
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Affiliation(s)
- Daniel L Hughes
- aNorth Wales Centre for Primary Care Research, College of Health and Behavioural Sciences, Bangor University bBetsi Cadwaladr University Health Board, Wrexham Maelor Hospital, Wrexham cDepartment of Epidemiology & Public Health, Health Behaviour Research Centre, University College London, London dDepartment of Public Health and Primary Care, Cambridge Centre for Health Services Research, University of Cambridge, Cambridge eWolfson Research Institute, School of Medicine, Pharmacy and Health, University of Durham, Stockton-on-Tees, UK
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Trends in survival of chronic lymphocytic leukemia patients in Germany and the USA in the first decade of the twenty-first century. J Hematol Oncol 2016; 9:28. [PMID: 27000264 PMCID: PMC4802710 DOI: 10.1186/s13045-016-0257-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 03/11/2016] [Indexed: 01/26/2023] Open
Abstract
Background Recent population-based studies in the United States of America (USA) and other countries have shown improvements in survival for patients with chronic lymphocytic leukemia (CLL) diagnosed in the early twenty-first century. Here, we examine the survival for patients diagnosed with CLL in Germany in 1997–2011. Methods Data were extracted from 12 cancer registries in Germany and compared to the data from the USA. Period analysis was used to estimate 5- and 10-year relative survival (RS). Results Five- and 10-year RS estimates in 2009–2011 of 80.2 and 59.5 %, respectively, in Germany and 82.4 and 64.7 %, respectively, in the USA were observed. Overall, 5-year RS increased significantly in Germany and the difference compared to the survival in the USA which slightly decreased between 2003–2005 and 2009–2011. However, age-specific analyses showed persistently higher survival for all ages except for 15–44 in the USA. In general, survival decreased with age, but the age-related disparity was small for patients younger than 75. In both countries, 5-year RS was >80 % for patients less than 75 years of age but <70 % for those age 75+. Conclusions Overall, 5-year survival for patients with CLL is good, but 10-year survival is significantly lower, and survival was much lower for those age 75+. Major differences in survival between countries were not observed. Further research into ways to increase survival for older CLL patients are needed to reduce the persistent large age-related survival disparity.
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Risk of Second Primary Cancers in Multiple Myeloma Survivors in German and Swedish Cancer Registries. Sci Rep 2016; 6:22084. [PMID: 26908235 PMCID: PMC4764950 DOI: 10.1038/srep22084] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/05/2016] [Indexed: 12/04/2022] Open
Abstract
We aimed at investigating the distribution and risk of second primary cancers (SPCs) in multiple myeloma (MM) survivors in Germany and Sweden to provide etiological understanding of SPCs and insight into their incidence rates and recording practices. MM patients diagnosed in 1997–2010 at age ≥15 years were selected from the Swedish (nationwide) and 12 German cancer registries. Standardized incidence ratios (SIRs) were used to assess risk of a specific SPC compared to risk of the same first cancer in the corresponding background population. Among 18,735 survivors of first MM in Germany and 7,560 in Sweden, overall 752 and 349 SPCs were recorded, respectively. Significantly elevated SIRs of specific SPCs were observed for acute myeloid leukemia (AML; SIR = 4.9) in Germany and for kidney cancer (2.3), AML (2.3) and nervous system cancer (1.9) in Sweden. Elevated risk for AML was more pronounced in the earlier diagnosis period compared to the later, i.e., 9.7 (4.2–19) for 1997–2003 period versus 3.5 (1.5–6.9) for 2004–2010 in Germany; 3.8 (1.4–8.3) for 1997–2003 versus 2.2 (0.3–7.8) for 2004–2010 in Sweden. We found elevated risk for AML for overall, early diagnosis periods and longer follow-up times in both populations, suggesting possible side effects of treatment for MM patients.
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Brenner H, Castro FA, Eberle A, Emrich K, Holleczek B, Katalinic A, Jansen L. Death certificate only proportions should be age adjusted in studies comparing cancer survival across populations and over time. Eur J Cancer 2016; 52:102-8. [DOI: 10.1016/j.ejca.2015.10.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 10/19/2015] [Accepted: 10/23/2015] [Indexed: 11/24/2022]
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Distribution and risk of the second discordant primary cancers combined after a specific first primary cancer in German and Swedish cancer registries. Cancer Lett 2015; 369:152-66. [DOI: 10.1016/j.canlet.2015.08.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/17/2015] [Accepted: 08/17/2015] [Indexed: 01/20/2023]
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Compaci G, Rueter M, Lamy S, Oberic L, Recher C, Lapeyre-Mestre M, Laurent G, Despas F. Ambulatory Medical Assistance--After Cancer (AMA-AC): A model for an early trajectory survivorship survey of lymphoma patients treated with anthracycline-based chemotherapy. BMC Cancer 2015; 15:781. [PMID: 26498342 PMCID: PMC4619467 DOI: 10.1186/s12885-015-1815-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 10/16/2015] [Indexed: 12/21/2022] Open
Abstract
Background Cancer survivorship has emerged as an important aspect of oncology due to the possibility of physical and psychosocial complications. The purpose of this study was to assess the feasibility of the Ambulatory Medical Assistance for After Cancer (AMA-AC) procedure for monitoring lymphoma survivorship during the first year after chemotherapy. Methods AMA-AC is based on systematic general practitioner (GP) consultations and telephone interventions conducted by a nurse coordinator (NC) affiliated to the oncology unit, while an oncologist acts only on demand. Patients are regularly monitored for physical, psychological and social events, as well as their health-related quality of life (HRQoL). Inclusion criteria were patients newly diagnosed with non-Hodgkin or Hodgkin lymphomas, who had been treated with anthracycline-based chemotherapy and were in complete remission after treatment. Results All 115 patients and 113 collaborating GPs agreed to participate in the study. For patients who achieved one year of disease-free survival (n = 104) their assessments (438 in total) were fully completed. Eleven were excluded from analysis (9 relapses and 2 deaths). The most frequent complications when taking into account all grades were arthralgia (64.3 %) and infections (41.7 %). About one third of patients developed new diseases with cardiovascular complications as the most common. Psychological disorders such as anxiety, depression and post-traumatic stress disorder were diagnosed in 42.6 % of patients. The data collected showed that Hodgkin lymphoma patients, females, and patients with lower HRQoL (mental component) at study entry were at greater risk for developing at least one psychological disorder. Conclusion This study showed that AMA-AC is a feasible and efficient procedure for monitoring lymphoma survivorship in terms of GP and patient participation rates and adherence, and provides a high quality of operable data. Hence, the AMA-AC procedure may be transferable into clinical daily practice as an alternative to standard oncologist-based follow-up. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1815-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gisèle Compaci
- Department of Hematology - Internal Medicine, Toulouse University Hospital, Cancer University Institute of Toulouse Oncopole, Toulouse, France.
| | - Manuela Rueter
- INSERM Unit 1027 (The French National Institute of Health and Medical Research), Faculty of Medicine, Toulouse, France. .,Service of Medical and Clinical Pharmacology, Center of Pharmacovigilance, Pharmaco-epidemiology and Information on Drugs, Toulouse University Hospital, 37 Allées Jules Guesde, 31000, Toulouse, France.
| | - Sébastien Lamy
- INSERM Unit 1027 (The French National Institute of Health and Medical Research), Faculty of Medicine, Toulouse, France. .,Service of Medical and Clinical Pharmacology, Center of Pharmacovigilance, Pharmaco-epidemiology and Information on Drugs, Toulouse University Hospital, 37 Allées Jules Guesde, 31000, Toulouse, France. .,Department of Epidemiology, Health Economics and Public Health, Faculty of Medicine, University of Toulouse III Paul Sabatier, Toulouse, France.
| | - Lucie Oberic
- Department of Hematology - Internal Medicine, Toulouse University Hospital, Cancer University Institute of Toulouse Oncopole, Toulouse, France.
| | - Christian Recher
- Department of Hematology - Internal Medicine, Toulouse University Hospital, Cancer University Institute of Toulouse Oncopole, Toulouse, France. .,INSERM Unit 1037 (The French National Institute of Health and Medical Research), Center of Cancer Research, Toulouse, France.
| | - Maryse Lapeyre-Mestre
- INSERM Unit 1027 (The French National Institute of Health and Medical Research), Faculty of Medicine, Toulouse, France. .,Service of Medical and Clinical Pharmacology, Center of Pharmacovigilance, Pharmaco-epidemiology and Information on Drugs, Toulouse University Hospital, 37 Allées Jules Guesde, 31000, Toulouse, France. .,Laboratory of Medical and Clinical Pharmacology Faculty of Medicine, University III Paul Sabatier, Toulouse, France.
| | - Guy Laurent
- Department of Hematology - Internal Medicine, Toulouse University Hospital, Cancer University Institute of Toulouse Oncopole, Toulouse, France. .,INSERM Unit 1027 (The French National Institute of Health and Medical Research), Faculty of Medicine, Toulouse, France.
| | - Fabien Despas
- INSERM Unit 1027 (The French National Institute of Health and Medical Research), Faculty of Medicine, Toulouse, France. .,Service of Medical and Clinical Pharmacology, Center of Pharmacovigilance, Pharmaco-epidemiology and Information on Drugs, Toulouse University Hospital, 37 Allées Jules Guesde, 31000, Toulouse, France. .,Laboratory of Medical and Clinical Pharmacology Faculty of Medicine, University III Paul Sabatier, Toulouse, France.
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Castro FA, Jansen L, Krilaviciute A, Katalinic A, Pulte D, Sirri E, Ressing M, Holleczek B, Luttmann S, Brenner H. Survival of patients with gastric lymphoma in Germany and in the United States. J Gastroenterol Hepatol 2015; 30:1485-91. [PMID: 25967274 DOI: 10.1111/jgh.12989] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM This study aims to examine survival for gastric lymphomas and its main subtypes, mucosa-associated lymphoid tissue lymphoma (MALT), and diffuse large B-cell lymphoma (DLBCL), in Germany and in the United States. METHODS Data for patients diagnosed in 1997-2010 were used from 10 population-based German cancer registries and compared to the data from the US Surveillance, Epidemiology and End Results (SEER) 13 registries database. Patients age 15-74 diagnosed with gastric lymphomas were included in the analysis. Period analysis and modeled period analysis were used to estimate 5-year and 10-year relative survival (RS) in 2002-2010 and survival trends from 2002-2004 to 2008-2010. RESULTS Overall, the database included 1534 and 2688 patients diagnosed with gastric lymphoma in 1997-2010 in Germany and in the United States, respectively. Survival was substantially higher for MALT (5-year and 10-year RS: 89.0% and 80.9% in Germany, 93.8% and 86.8% in the United States) than for DLBCL (67.5% and 59.2% in Germany, and 65.3% and 54.7% in the United States) in 2002-2010. Survival was slightly higher among female patients and decreased by age for gastric lymphomas combined and its main subtypes. A slight, nonsignificant, increase in the 5-year RS for gastric lymphomas combined was observed in Germany and the United States, with increases in 5-year RS between 2002-2004 and 2008-2010 from 77.1% to 81.0% and from 77.3% to 82.0%, respectively. Five-year RS of MALT exceeded 90% in 2008-2010 in both countries. CONCLUSIONS Five-year RS of MALT meanwhile exceeds 90% in both Germany and the United States, but DLBCL has remained below 70% in both countries.
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Affiliation(s)
- Felipe A Castro
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Agne Krilaviciute
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Dianne Pulte
- Cardeza Foundation and Division of Hematology, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Eunice Sirri
- Lower Saxony Cancer Registry, Oldenburg, Germany
| | - Meike Ressing
- Cancer Registry of Rhineland-Palatinate, Institute of Medical Biostatistics Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Sabine Luttmann
- Cancer Registry of Bremen, Leibniz-Institute for Epidemiology and Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
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Coebergh JW, van den Hurk C, Louwman M, Comber H, Rosso S, Zanetti R, Sacchetto L, Storm H, van Veen EB, Siesling S, van den Eijnden-van Raaij J. EUROCOURSE recipe for cancer surveillance by visible population-based cancer RegisTrees® in Europe: From roots to fruits. Eur J Cancer 2015; 51:1050-63. [DOI: 10.1016/j.ejca.2015.02.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 02/05/2015] [Accepted: 02/06/2015] [Indexed: 12/11/2022]
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Coebergh JW, van den Hurk C, Rosso S, Comber H, Storm H, Zanetti R, Sacchetto L, Janssen-Heijnen M, Thong M, Siesling S, van den Eijnden-van Raaij J. EUROCOURSE lessons learned from and for population-based cancer registries in Europe and their programme owners: Improving performance by research programming for public health and clinical evaluation. Eur J Cancer 2015; 51:997-1017. [DOI: 10.1016/j.ejca.2015.02.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 02/03/2015] [Accepted: 02/03/2015] [Indexed: 01/20/2023]
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Brenner H, Jansen L. Restriction to period of interest improves informative value of death certificate only proportions in period analysis of cancer survival. J Clin Epidemiol 2015; 68:1432-9. [PMID: 25881488 DOI: 10.1016/j.jclinepi.2015.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 01/12/2015] [Accepted: 03/09/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The proportion of cases registered by death certificates only (DCO) is a widely used indicator for potential bias in cancer survival studies. Period analysis is increasingly used to derive up-to-date cancer survival estimates. We aimed to assess whether reported DCO proportions should be restricted to the specific recent calendar period ("restricted period") or refer to all diagnosis years of included patients ("full period"). STUDY DESIGN AND SETTING We assessed correlations of bias in period survival estimates resulting from DCO cases with DCO proportions in the restricted and full period, respectively. We used cancer registry data to simulate bias and DCO proportions resulting from various patterns of underreporting of deceased cases. We show results for six common cancers with very different prognosis and five different age groups. RESULTS In all scenarios, the expected bias was highly correlated with expected DCO proportions in both periods, but correlations were consistently higher with DCO proportions in the restricted period. CONCLUSION In period analyses of cancer survival, DCO proportions for the restricted period of specific interest are a better indicator of potential bias due to underreporting of deceased cases than DCO proportions for all years of diagnosis of included patients.
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Affiliation(s)
- Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg D-69120, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg D-69120, Germany.
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg D-69120, Germany
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[Leukemia incidence and survival in Germany according to current standardized categories]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:93-102. [PMID: 24357178 DOI: 10.1007/s00103-013-1869-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Leukemias include a large number of diverse malignancies concerning the blood-forming system. Population-based comparisons and time trends are complicated by inconsistent definitions and classifications. In the course of the European HAEMACARE project, a consensus grouping system was created based on the morphology codes of the ICD-O-3 (International Classification of Diseases-Oncology, third revision), consistent with the WHO classification published in 2008 and useful for epidemiologic and public health purposes. For the first time leukemia incidence and survival in Germany are presented according to this system on the basis of cancer registry data.. MATERIAL AND METHODS A set of leukemia cases diagnosed during 2001-2010 was extracted from the data submitted by German population-based cancer registries to the Robert Koch Institute in early 2013 and grouped according to the HAEMACARE system. Direct age-standardized incidence rates were calculated. To estimate the prognosis of adult leukemia patients diagnosed during 2008-2010, the 5-year relative survival was computed using the period approach. RESULTS AND DISCUSSION Based on 23,328 predominantly leukemic malignancies ascertained for six federal states over a 10-year period, the age-standardized incidence rates were 4.1 (per 100,000) for chronic lymphocytic leukemia, 3.1 for acute myeloid leukemia, and 2.4 for myeloproliferative neoplasms, similar to other European regions. The 5-year relative survival of leukemia in Germany currently ranges between 8 and 95% according to sex, age, and category, and is thus considerably better compared with results derived from a European data pool referring to 2000-2002.
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Jacke CO, Albert US, Reinhard I, Kalder M. Convergence with SEER database achieved by a breast cancer network: a longitudinal benchmark of 5-year relative survival. J Cancer Res Clin Oncol 2014; 141:1109-18. [PMID: 25512079 DOI: 10.1007/s00432-014-1879-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 11/18/2014] [Indexed: 01/02/2023]
Abstract
PURPOSE To benchmark outcomes of a German breast cancer network with the Surveillance Epidemiology and End Results programme (SEER) of the USA from a longitudinal point of view. METHODS All women receiving primary breast cancer therapy of three hospitals in a rural district of Marburg-Biedenkopf (Germany) of time intervals 1996-1997 and 2003-2004 were used to define local benchmark objects. Data from SEER-programme contributed longitudinal benchmark objects from national level (1988-2004). All benchmark objects were compared with the time-fixed benchmark reference of SEER (2004). Stage distributions and 5-year relative survival ratios were combined to estimate standardized screening-, case-mix-, work-up-, treatment- and relative overall performance index. RESULTS From the entry cohort of 877 German women, 97.7 % of the patients accounted for the institutional sample (N = 857) and 65.8 % accounted for the regional sample (N = 577). Stage distributions, relative survival ratios and indices of the German breast cancer network improved over time. Developed indices converged with SEER (2004). CONCLUSIONS Effectiveness gap between one exemplary German breast cancer network and international benchmark defined by SEER has been closed. Reasons are manifold, and further research is recommended.
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Affiliation(s)
- Christian O Jacke
- Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Square J5, 68159, Mannheim, Germany,
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Kowalski C, Ferencz J, Brucker SY, Kreienberg R, Wesselmann S. Quality of care in breast cancer centers: results of benchmarking by the German Cancer Society and German Society for Breast Diseases. Breast 2014; 24:118-23. [PMID: 25515645 DOI: 10.1016/j.breast.2014.11.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/27/2014] [Accepted: 11/22/2014] [Indexed: 12/16/2022] Open
Abstract
A total of 218 breast cancer centers, with 274 operating sites, have been certified since 2003 in accordance with the criteria set out by the German Cancer Society (Deutsche Krebsgesellschaft) and the German Society for Breast Diseases (Deutsche Gesellschaft für Senologie). Most of these centers are located in Germany, but centers in Austria, Switzerland, and Italy have also been certified. This paper presents the results for quality indicators (QIs) from 2009 to 2012, based on data from 195,342 primary breast cancer patients, in order to illustrate the development and progress of these centers. Descriptive results on interdisciplinary collaboration (6 QIs), guideline adherence (15 QIs), and specialist expertise (7 QIs) are reported over time. Fulfillment of the certification requirements was high and remained relatively stable over time, with the extent of variation between sites declining. Sites that do not reach the target values are asked to comment on the discrepancies, and their comments, as well as the QI results, are used by centers and auditors during an on-site auditing process and to constantly revise the QIs set out by the guideline and the certification commission.
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Affiliation(s)
| | - Julia Ferencz
- OnkoZert, Certification Institute of the German Cancer Society, Gartenstrasse 24, 89231 Neu-Ulm, Germany.
| | - Sara Y Brucker
- University Hospital Tübingen, Calwerstrasse 7, 72076 Tübingen, Germany.
| | - Rolf Kreienberg
- University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany.
| | - Simone Wesselmann
- German Cancer Society, Kuno-Fischer-Strasse 8, 14057 Berlin, Germany.
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Jansen L, Castro FA, Gondos A, Krilaviciute A, Barnes B, Eberle A, Emrich K, Hentschel S, Holleczek B, Katalinic A, Brenner H. Recent cancer survival in Germany: An analysis of common and less common cancers. Int J Cancer 2014; 136:2649-58. [DOI: 10.1002/ijc.29316] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 10/17/2014] [Indexed: 12/29/2022]
Affiliation(s)
- Lina Jansen
- Division of Clinical Epidemiology and Aging Research (C070); German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Felipe A. Castro
- Division of Clinical Epidemiology and Aging Research (C070); German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Adam Gondos
- Division of Clinical Epidemiology and Aging Research (C070); German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Agne Krilaviciute
- Division of Clinical Epidemiology and Aging Research (C070); German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Benjamin Barnes
- National Center for Cancer Registry Data; Robert Koch Institute; Berlin Germany
| | - Andrea Eberle
- Cancer Registry of Bremen; Leibniz-Institute for Prevention Research and Epidemiology - BIPS; Bremen Germany
| | - Katharina Emrich
- Cancer Registry of Rhineland-Palatinate; Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz; Mainz Germany
| | - Stefan Hentschel
- Hamburg Cancer Registry; Authority for Health and Consumer Protection; Hamburg Germany
| | | | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research (C070); German Cancer Research Center (DKFZ); Heidelberg Germany
- German Cancer Consortium (DKTK); Heidelberg Germany
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Eisemann N, Waldmann A, Garbe C, Katalinic A. Development of a microsimulation of melanoma mortality for evaluating the effectiveness of population-based skin cancer screening. Med Decis Making 2014; 35:243-54. [PMID: 25145574 DOI: 10.1177/0272989x14543106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND A nationwide skin cancer screening (SCS) was implemented in Germany in 2008. It aims at improving early detection of melanoma in order to reduce melanoma mortality. While the idea of early detection is compelling, demonstrating the effectiveness of melanoma screening is crucial. Since it is not feasible to conduct epidemiological studies to investigate the impact of factors such as screening interval or targeted age groups, we developed a microsimulation model that is able to predict melanoma mortality in Germany under several SCS conditions. METHODS Using German cancer registry data, population data, and other published data on melanoma progression and screening participation, we developed a stochastic microsimulation model. With this model, 10,000 populations of 100,000 persons and their melanoma-related life histories were simulated separately for women and for men and calibrated to observed melanoma incidence. In a second step, life histories of melanoma were changed by an SCS. RESULTS Compared with a nonscreening scenario (age-standardized mortality rate: 1.6 and 2.9 per 100,000 for women and men), a biennial SCS of the 35- to 85-year-old population with a participation probability of 20% for each screening-eligible individual and a test sensitivity of 80% reduced mortality by up to 0.7 and 1.4 deaths per 100,000 person-years for women and men, respectively, corresponding to a relative reduction of melanoma mortality by 45% in women and men. CONCLUSIONS We developed a microsimulation model of melanoma mortality that can be used to evaluate the effectiveness of population-based skin cancer screening. The simulation provided plausible melanoma mortality predictions and is a tool for comparing different SCS scenarios. However, it does not provide estimates on total costs of SCS.
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Affiliation(s)
- Nora Eisemann
- Institute of Cancer Epidemiology, University of Lübeck, Lübeck, Germany (NE, AK)
| | - Annika Waldmann
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany (AW, AK)
| | - Claus Garbe
- Department of Dermatology, University of Tübingen, Tübingen, Germany (CG)
| | - Alexander Katalinic
- Institute of Cancer Epidemiology, University of Lübeck, Lübeck, Germany (NE, AK),Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany (AW, AK)
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Stang A, Büchel C. A novel approach for estimating the nationwide incidence of renal cancer. Emerg Themes Epidemiol 2014; 11:8. [PMID: 25057278 PMCID: PMC4108273 DOI: 10.1186/1742-7622-11-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 06/30/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The aim of this study was to provide a novel approach for estimating the incidence of renal cancer in Germany by using hospitalization data from the years 2005-2006 and to compare these estimates with incidence rates from cancer registries. We used nationwide hospitalization data from the years 2005-2006 including 34.2 million hospitalizations. We used three definitions of potential incident renal cancer cases: 1) a main or secondary diagnosis of renal cancer and a partial or total nephrectomy; 2) a main diagnosis of renal cancer and a partial or total nephrectomy; and 3) a main diagnosis of renal cancer (without a secondary diagnosis of renal pelvis cancer) and a partial or total nephrectomy. In addition, we used cancer registry data for comparison of rates. RESULTS Hospitalization data to which definition 2 applied provided incidence rate estimates nearly identical to those provided by the cancer registries (when the cases registered from death certificates only were excluded). Age-standardized (European standard population) incidence rates based on hospitalization data and cancer registry data were 15.6 per 100 000 and 15.7 per 100 000 among men and 8.0 per 100 000 and 7.6 per 100 000 among women respectively. Cancer registry-based incidence rates were lower especially among those federal states with an estimated completeness of registration below 90% (Berlin and Saxony-Anhalt). CONCLUSIONS Representative hospitalization data can be used to estimate incidence rates of renal cancer. We propose that incidence rates can be estimated by hospitalization data if 1) the primary treatment is performed during an in-hospital stay and 2) nearly all patients undergo a defined surgical procedure that is not repeated for the treatment of the same cancer. Our results may be useful for countries with no or incomplete cancer registration or for countries that use hospitalization data to provide a representative incidence of renal cancer.
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Affiliation(s)
- Andreas Stang
- Institut für Klinische Epidemiologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Saxony-Anhalt 06097, Germany
- School of Public Health, Department of Epidemiology Boston University, 715 Albany Street, Talbot Building, Boston, MA 02118, USA
- Profilzentrum für Gesundheitswissenschaften (PZG) der Medizinischen Fakultät der Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Saxony-Anhalt 06097, Germany
| | - Christian Büchel
- Institut für Klinische Epidemiologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Saxony-Anhalt 06097, Germany
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Nennecke A, Geiss K, Hentschel S, Vettorazzi E, Jansen L, Eberle A, Holleczek B, Gondos A, Brenner H. Survival of cancer patients in urban and rural areas of Germany—A comparison. Cancer Epidemiol 2014; 38:259-65. [DOI: 10.1016/j.canep.2014.02.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 01/23/2014] [Accepted: 02/23/2014] [Indexed: 10/25/2022]
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Kunisawa S, Yamashita K, Ikai H, Otsubo T, Imanaka Y. Survival analyses of postoperative lung cancer patients: an investigation using Japanese administrative data. SPRINGERPLUS 2014; 3:217. [PMID: 24826376 PMCID: PMC4018473 DOI: 10.1186/2193-1801-3-217] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 04/24/2014] [Indexed: 11/10/2022]
Abstract
Long-term survival rates of cancer patients represent important information for policymakers and providers, but analyses from voluntary cancer registries in Japan may not reflect the overall situation. In 2003, the Diagnosis Procedure Combination Per-Diem Payment System (DPC/PDPS) for hospital reimbursement was introduced in Japan; more than half of Japan's acute care beds are currently covered under this system. Administrative data produced under the DPC system include claims data and clinical summaries for each admission. Due to the large amount of data spanning multiple institutions, this database may have applications in providing a more general and inclusive overview of healthcare. Here, we investigate the use of administrative data for analyses of long-term survival in cancer patients. We analyzed postoperative survival in 7,064 patients with primary non-small cell lung cancer admitted to 102 hospitals between April 2008 and March 2013 using DPC data. Survival was defined at the last date of examination or discharge within the study period, and the event was mortality during the same period. Overall survival rates for different cancer stages were calculated using the Kaplan-Meier method. Additionally, survival rates of cancer patients at clinical stage IA were compared between low- and high-volume hospitals using the Log-rank test. Postoperative 5-year survival for patients at stage IA was 85.8% (95% CI = 78.6%-93.0%). High-volume hospitals had higher survival rates than hospitals with lower volume. Our findings using large-scale administrative data were similar to previous clinical registry reports, showing potential applications as a new method in analyzing up-to-date healthcare information.
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Affiliation(s)
- Susumu Kunisawa
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto City, 606-8501 Kyoto, Japan
| | - Kazuto Yamashita
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto City, 606-8501 Kyoto, Japan
| | - Hiroshi Ikai
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto City, 606-8501 Kyoto, Japan
| | - Tetsuya Otsubo
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto City, 606-8501 Kyoto, Japan
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto City, 606-8501 Kyoto, Japan
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Pavlík T, Májek O, Büchler T, Vyzula R, Petera J, Ryska M, Ryška A, Cibula D, Babjuk M, Abrahámová J, Vorlíček J, Mužík J, Dušek L. Trends in stage-specific population-based survival of cancer patients in the Czech Republic in the period 2000–2008. Cancer Epidemiol 2014; 38:28-34. [DOI: 10.1016/j.canep.2013.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 10/16/2013] [Accepted: 11/14/2013] [Indexed: 12/23/2022]
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Pulte D, Jansen L, Gondos A, Katalinic A, Barnes B, Ressing M, Holleczek B, Eberle A, Brenner H. Survival of adults with acute lymphoblastic leukemia in Germany and the United States. PLoS One 2014; 9:e85554. [PMID: 24475044 PMCID: PMC3903479 DOI: 10.1371/journal.pone.0085554] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 12/04/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Adulthood acute lymphoblastic leukemia (ALL) is a rare disease. In contrast to childhood ALL, survival for adults with ALL is poor. Recently, new protocols, including use of pediatric protocols in young adults, have improved survival in clinical trials. Here, we examine population level survival in Germany and the United States (US) to gain insight into the extent to which changes in clinical trials have translated into better survival on the population level. METHODS Data were extracted from the Surveillance, Epidemiology, and End Results database in the US and 11 cancer registries in Germany. Patients age 15-69 diagnosed with ALL were included. Period analysis was used to estimate 5-year relative survival (RS). RESULTS Overall 5-year RS was estimated at 43.4% for Germany and 35.5% for the US (p = 0.004), with a decrease in survival with increasing age. Survival was higher in Germany than the US for men (43.6% versus 37.7%, p = 0.002) but not for women (42.4% versus 40.3%, p>0.1). Five-year RS estimates increased in Germany and the US between 2002 and 2006 by 11.8 and 7.3 percent units, respectively (p = 0.02 and 0.04, respectively). CONCLUSIONS Survival for adults with ALL continues to be low compared with that for children, but a substantial increase in 5-year survival estimates was seen from 2002 to 2006 in both Germany and the US. The reasons for the survival differences between both countries require clarification.
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Affiliation(s)
- Dianne Pulte
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cardeza Foundation and Division of Hematology, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Adam Gondos
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Benjamin Barnes
- National Center for Cancer Registry Data, Robert Koch Institute, Berlin, Germany
| | - Meike Ressing
- Cancer Registry of Rhineland-Palatinate, Institute of Medical Biostatistics, Epidemiology, and Informatics, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Andrea Eberle
- Cancer Registry of Bremen, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
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Pulte D, Jansen L, Gondos A, Emrich K, Holleczek B, Katalinic A, Brenner H. Improved population level survival in younger Hodgkin lymphoma patients in Germany in the early 21st century. Br J Haematol 2014; 164:851-7. [DOI: 10.1111/bjh.12722] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 10/02/2013] [Indexed: 01/22/2023]
Affiliation(s)
- Dianne Pulte
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Centre; Heidelberg Germany
- Division of Hematology; Department of Medicine; Thomas Jefferson University; Philadelphia PA USA
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Centre; Heidelberg Germany
| | - Adam Gondos
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Centre; Heidelberg Germany
| | - Katharina Emrich
- Cancer Registry of Rhineland-Palatinate Institute for Medical Biostatistics; Epidemiology and Informatics; University Medical Centre; Johannes Gutenberg University Mainz; Mainz Germany
| | | | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Centre; Heidelberg Germany
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Second primary cancers after cancer of unknown primary in Sweden and Germany: efficacy of the modern work-up. Eur J Cancer Prev 2013; 22:210-4. [PMID: 22960777 DOI: 10.1097/cej.0b013e3283592c62] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In unsparing efforts to find the hidden primaries, second primary cancers (SPCs) unrelated to cancer of unknown primary (CUP) are found. The detection rates of SPCs after CUP can be considered as measures for the effectiveness of modern diagnostic techniques in finding tumors. We aimed to compare the rates of specific SPCs found after the work-up of CUP and the more sign/symptom-directed diagnostic approaches applied after any other cancer. The number of CUP patients identified in the nationwide Swedish database and nine German cancer registries was 24 641 from 1997 through 2006, and rate ratios (RRs) for SPCs were recorded in two follow-up periods. The detection rate of SPCs immediately after any other cancer was about two times higher in Germany than in Sweden, but the rate immediately after CUP was almost the same for the two datasets. In the joint analyses after CUP, the RRs of liver, lung, breast, and kidney cancers were higher than after any other cancer, whereas the RRs of prostate, urinary bladder, and connective tissue cancers as well as non-Hodgkin's lymphoma were not significantly different; the RR of cancers of upper aerodigestive tract was lower after CUP than after any other cancer. The joint data indicate that the work-up is efficient in detecting tumors in the thoracoabdominal organs that are screened by computed tomography. For some other organ sites, the more sign/symptom-directed diagnostic approaches may be equally efficient. However, none of the applied techniques could detect all tumors immediately after the first diagnosis.
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Jansen L, Eberle A, Emrich K, Gondos A, Holleczek B, Kajüter H, Maier W, Nennecke A, Pritzkuleit R, Brenner H. Socioeconomic deprivation and cancer survival in Germany: an ecological analysis in 200 districts in Germany. Int J Cancer 2013; 134:2951-60. [PMID: 24259308 DOI: 10.1002/ijc.28624] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 10/23/2013] [Accepted: 11/04/2013] [Indexed: 11/06/2022]
Abstract
Although socioeconomic inequalities in cancer survival have been demonstrated both within and between countries, evidence on the variation of the inequalities over time past diagnosis is sparse. Furthermore, no comprehensive analysis of socioeconomic differences in cancer survival in Germany has been conducted. Therefore, we analyzed variations in cancer survival for patients diagnosed with one of the 25 most common cancer sites in 1997-2006 in ten population-based cancer registries in Germany (covering 32 million inhabitants). Patients were assigned a socioeconomic status according to the district of residence at diagnosis. Period analysis was used to derive 3-month, 5-year and conditional 1-year and 5-year age-standardized relative survival for 2002-2006 for each deprivation quintile in Germany. Relative survival of patients living in the most deprived district was compared to survival of patients living in all other districts by model-based period analysis. For 21 of 25 cancer sites, 5-year relative survival was lower in the most deprived districts than in all other districts combined. The median relative excess risk of death over the 25 cancer sites decreased from 1.24 in the first 3 months to 1.16 in the following 9 months to 1.08 in the following 4 years. Inequalities persisted after adjustment for stage. These major regional socioeconomic inequalities indicate a potential for improving cancer care and survival in Germany. Studies on individual-level patient data with access to treatment information should be conducted to examine the reasons for these socioeconomic inequalities in cancer survival in more detail.
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Affiliation(s)
- Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Abstract
Oesophageal carcinoma reflects a tumor entity which can be optimally treated with multimodal therapy. Early lymphatic spread and late symptoms lead to mostly advanced tumors at primary diagnosis, which means that they can not be cured by surgery alone. On the other hand these tumors show high sensitivity towards chemo- and radiotherapy. Chemoradiotherapy followed by surgery (trimodal therapy) is considered an international standard of care for operable patients. Definitive chemoradiotherapy or the flexible concept of chemoradiotherapy with optional salvage surgery can be curative options for patients with increased operative risk.
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