Oral Cancer Incidence, Mortality, and Mortality-to-Incidence Ratio Are Associated with Human Development Index in China, 1990–2019

Disparities in 36 cancers across 185 countries: secondary analysis of global cancer statistics

Cancer is a major public health problem and represents substantial disparities worldwide. This study reported estimates for 36 cancers across 185 countries by incidence, mortality, 5-year prevalence, mortality-to-prevalence ratio (MPR), and mortality-to-incidence ratio (MIR) to examine its association with human development index (HDI) and gross national income (GNI). Data were collected from the GLOBOCAN 2020. MPR and MIR were calculated by sex, age group, country, and cancer type and then summarized into totals. Segi's population and global cancer spectrum were used to calculate age- and type-standardized ratios. Correlation analyses were conducted to assess associations. Results showed that breast cancer was the most diagnosed cancer globally. Low- and middle-income countries had high MPR and MIR. Cancers of esophagus, pancreas, and liver had the highest ratios. Males and the older population had the highest ratios. HDI and GNI were positively correlated with incidence and mortality but negatively correlated with MPR/MIR. Substantial disparities in cancer burden were observed among 36 cancer types across 185 countries. Socioeconomic development may contribute to narrowing these disparities, and tailored strategies are crucial for regional- and country-specific cancer control.

First‑line programmed cell death 1 inhibitor plus chemotherapy vs. standard treatment in patients with recurrent or metastatic oral squamous cell carcinoma: A retrospective cohort study

Programmed cell death 1 (PD-1) inhibitor revives the killing effect of immune cells to prevent tumor progression. The present study aimed to evaluate the efficacy and safety of first-line PD-1 inhibitor + chemotherapy vs. standard treatment in recurrent or metastatic (R/M) oral squamous cell carcinoma (OSCC). A total of 51 patients with R/M OSCC were reviewed and divided into the PD-1 inhibitor + chemotherapy (n=21) and standard treatment (n=30) groups based on their actual treatments. The results of the present study demonstrated that the objective response rate (52.4 vs. 36.7%, P=0.265) and disease control rate (81.0 vs. 70.0%, P=0.377) were numerically elevated in the PD-1 inhibitor + chemotherapy group compared with those in the standard treatment group; however, the results did not reach statistical significance. The progression-free survival (PFS) was numerically increased (without statistical significance) in the PD-1 inhibitor + chemotherapy group compared with that of the standard treatment group (P=0.057). Specifically, the PD-1 inhibitor + chemotherapy group and the standard treatment group exhibited a median [95% confidence interval (CI)] PFS duration of 6.7 (1.6-11.8) and 5.2 (3.4-7.0) months, respectively. In addition, the PD-1 inhibitor + chemotherapy group demonstrated increased overall survival (OS) compared with that of the standard treatment group (P=0.032). Specifically, the PD-1 inhibitor + chemotherapy group and the standard treatment group exhibited a median (95% CI) OS duration of 18.3 (11.9-24.7) and 10.3 (7.9-12.7) months, respectively. Furthermore, multivariate Cox regression analysis indicated that PD-1 inhibitor + chemotherapy was independently associated with improved PFS [hazard ratio (HR)=0.308, P=0.002] and OS (HR=0.252, P=0.003). In addition, the incidence of grade 3-5 adverse events (AEs) was relatively low in both groups and the incidence of any grade of each AE was not significantly different between groups (all P>0.050). In conclusion, the first-line PD-1 inhibitor + chemotherapy group had improved efficacy and comparable safety compared with those of the standard treatment in patients with R/M OSCC.

Analyzing Global Cancer Control: Progress of National Cancer Control Programs through Composite Indicators and Regression Modeling

Aim

Cancer is a significant public health concern, and National Cancer Control Programs (NCCPs) are crucial for reducing its burden. However, assessing the progress of NCCPs is challenging due to the complexity of cancer control outcomes and the various factors that influence them. Composite indicators can provide a comprehensive and accurate assessment of NCCP progress.

Materials and Methods

The dataset was compiled for 144 countries and comprised eight composite indices and two high-level comparative indicators (mortality-to-cancer incidence ratio [MIR] and 5-year cancer prevalence-to-incidence ratio [PCIR]) representing NCCP outcomes. Two large databases and six annual composite index reports were consulted. Linear regression analysis and Pearson correlation coefficients were used to establish a relationship between indicators and NCCP outcomes. A multiple regression machine learning model was generated to further improve the accuracy of NCCP outcome prediction.

Results

High-income countries had the highest cancer incidence, whereas low-income countries had the highest MIR. Linear regression analysis indicated a negative trend between all composite indicators and MIR, whereas a positive trend was observed with PCIR. The Human Development Index and the Legatum Prosperity Index had the highest adjusted R 2 values for MIR (0.74 and 0.73) and PCIR (0.86 and 0.81), respectively. Multiple linear regression modeling was performed, and the results indicated a low mean squared error score (-0.02) and a high R 2 score (0.86), suggesting that the model accurately predicts NCCP outcomes.

Conclusions

Overall, composite indicators can be an effective tool for evaluating NCCP, and the results of this study can aid in the development and keeping track of NCCP progress for better cancer control.

Mortality and associated influencing factors among oral cancer patients in western China: A retrospective cohort study from 2016 to 2021

Few studies have examined oral cancer-related mortality in Guangxi. This study aimed to explore the incidence and characteristics of oral cancer and to identify the risk factors for oral cancer-related mortality. The study was conducted to provide a reference for clinical treatment and to improve the survival rate of patients with oral cancer. A total of 271 patients with oral cancer who were treated in the Stomatology Hospital of Guangxi Medical University from 2016 to 2017 were selected as the research subjects. The follow-up lasted until the middle of 2021. The survival rate and mean survival time of 271 patients were calculated by the Kaplan-Meier method. Cox proportional hazard models and stratified analysis were used to explore the related factors that affect the mortality of patients. Nomogram plots were used to visualize the relationships among multiple variables. Among 271 patients with oral cancer, the 2-year and 5-year overall survival rates were 83.8% and 68.5% respectively. The results of multivariate analysis showed that, age, pathological type, surgery and readmission were significant factors affecting survival. When the above factors were incorporated into nomogram plots and stratified analysis, the results showed that the risk of death after treatment in patients with oral cancer aged > 55 years was 1.693 times higher than that in patients aged ≤ 55 years (HR, hazard ratio [HR] = 1.795, 95% confidence intervals [CI] = 1.073, 3.004). The risk of death after surgical treatment was 0.606 times higher than that without surgical treatment (HR = 0.590, 95% CI = 0.367, 0.948). Patients who were readmitted had a 2.340-fold increased risk of death compared with patients who were not readmitted (HR = 2.340, 95% CI = 1.267,4.321). Older age, surgery, and readmission were risk factors for mortality among patients with oral cancer. The median survival time of 271 patients with oral cancer was 52.0 months. Patients under the age of 55 years old and those who choose surgical treatment tend to have a better prognosis and a longer survival. Oral cancer-related mortality is affected by age, treatment mode, readmission, and other factors. All of these factors are worthy of clinical attention for their prevention and control.

New Regional Dynamic Cancer Model across the European Union

BACKGROUND

Can increasing levels of economic wealth significantly influence changes in cancer incidence and mortality rates?

METHODS

We investigated this issue by means of regression analyses based on the study of incidence and mortality indicators for lip, oral cavity, and pharyngeal; colon; pancreatic; lung; leukaemia; brain and central nervous system cancers in correlation with the levels of economic welfare and financial allocations to health at the level of the European Union member states, with the exception of Luxembourg and Cyprus for which there are no official statistical data reported.

RESULTS

The results of the study showed that there were significant disparities both regionally and by gender, requiring corrective public policy measures that were formulated in this study.

CONCLUSIONS

The conclusions highlight the main findings of the study in terms of the evolution of the disease, present the significant aspects that characterise the evolution of each type of cancer during the period analysed (1993-2021), and highlight the novelty and limitations of the study and future directions of research. As a result, increasing economic welfare is a potential factor in halting the effects of cancer incidence and mortality at the population level, while the financial allocations to health of EU member countries' budgets are a drawback due to large regional disparities.

Lip and Oral Cavity Cancer Incidence and Mortality Rates Associated with Smoking and Chewing Tobacco Use and the Human Development Index in 172 Countries Worldwide: An Ecological Study 2019-2020

Tobacco use is associated with diseases worldwide, including cancer. This is one of the major public health problems globally, causing more than 19 million new cases in 2020. Lip and oral cavity cancer (LOCC) is neoplastic growth in the tongue, gums, and lips. The objective of this ecological study was to quantify the strength of the association between incidence and mortality of LOCC, with tobacco use and with the Human Development Index (HDI). Incidence and mortality data on LOCC were obtained for 172 countries in 2020, from the Global Cancer Observatory (GLOBOCAN). The prevalence of tobacco smoking and chewing was obtained from reports conducted in 2019. The inequality in human development was estimated using the HDI from the United Nations Development Program, Human Development Report (2019). Statistically significant correlations were observed between the incidence of LOCC and tobacco smoking and chewing prevalence, except for negative correlations between the prevalence of tobacco smoking LOCC mortality in women, just as in the case of the HDI. No statistically significant differences were found between the prevalence of tobacco chewing only and the incidence of LOCC overall and by sex. A higher LOCC incidence overall and by sex was associated with higher HDI. In conclusion, the present study found positive correlations for various HDI socioeconomic indicators and tobacco use with the incidence and mortality of LOCC, but also a few inverse correlations.

Global disease burden and trends of leukemia attributable to occupational risk from 1990 to 2019: An observational trend study

Background

Leukemia caused by occupational risk is a problem that needs more attention and remains to be solved urgently, especially for acute lymphoid leukemia (ALL), acute myeloid leukemia (AML), and chronic lymphoid leukemia (CLL). However, there is a paucity of literature on this issue. We aimed to assess the global burden and trends of leukemia attributable to occupational risk from 1990 to 2019.

Methods

This observational trend study was based on the Global Burden of Disease (GBD) 2019 database, the global deaths, and disability-adjusted life years (DALYs), which were calculated to quantify the changing trend of leukemia attributable to occupational risk, were analyzed by age, year, geographical location, and socio-demographic index (SDI), and the corresponding estimated annual percentage change (EAPC) values were calculated.

Results

Global age-standardized DALYs and death rates of leukemia attributable to occupational risk presented significantly decline trends with EAPC [-0.38% (95% CI: -0.58 to -0.18%) for DALYs and -0.30% (95% CI: -0.45 to -0.146%) for death]. However, it was significantly increased in people aged 65-69 years [0.42% (95% CI: 0.30-0.55%) for DALYs and 0.38% (95% CI: 0.26-0.51%) for death]. At the same time, the age-standardized DALYs and death rates of ALL, AML, and CLL were presented a significantly increased trend with EAPCs [0.78% (95% CI: 0.65-0.91%), 0.87% (95% CI: 0.81-0.93%), and 0.66% (95% CI: 0.51-0.81%) for DALYs, respectively, and 0.75% (95% CI: 0.68-0.82%), 0.96% (95% CI: 0.91-1.01%), and 0.55% (95% CI: 0.43-0.68%) for death], respectively. The ALL, AML, and CLL were shown an upward trend in almost all age groups.

Conclusion

We observed a substantial reduction in leukemia due to occupational risks between 1990 and 2019. However, the people aged 65-69 years and burdens of ALL, AML, and CLL had a significantly increased trend in almost all age groups. Thus, there remains an urgent need to accelerate efforts to reduce leukemia attributable to occupational risk-related death burden in this population and specific causes.