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Godoy-Casasbuenas N, Rincón CJ, Gil F, Arias N, Uribe Pérez C, Yépez MC, de Vries E. Age-period-cohort effects on incidence trends of childhood leukemia from four population-based cancer registries in Colombia. Cancer Epidemiol 2024; 89:102548. [PMID: 38428302 DOI: 10.1016/j.canep.2024.102548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/10/2024] [Accepted: 02/18/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Childhood leukemia (CL) is the most prevalent form of pediatric cancer on a global scale. However, there is a limited understanding of the dynamics of CL incidence in South America, with a specific knowledge gap in Colombia. This study aimed to identify trends in CL incidence and to analyze the effects of age, period, and birth cohort on the risk of leukemia incidence in this population. METHODS Information on all newly diagnosed leukemia cases (in general and by subtype) among residents aged 0-18 years and living in the serving areas of population-based cancer registries of Cali (2008-2017), Bucaramanga (2000-2017), Manizales (2003-2017), and Pasto (1998-2018). Estimated annual percent changes (EAPC) in incidence over time and potential changes in the slope of these EAPCs were calculated using joinpoint regression models. The effects of age, period, and cohort in CL incidence trends were evaluated using age-period-cohort models addressing the identifiability issue through the application of double differences. RESULTS A total of 966 childhood leukemia cases were identified. The average standardized incidence rate (ASIR) of leukemia was calculated and expressed per 100,000 person-years - observing ASIR of 4.46 in Cali, 7.27 in Bucaramanga, 3.89 in Manizales and 4.06 in Pasto. Concerning CL trends there were no statistically significant changes in EAPC throughout the different periods, however, when analyzed by leukemia subtype, statistically significant changes were observed in the EAPC for both ALL and AML. Analysis of age-period-cohort models revealed that age-related factors significantly underpin the incidence trends of childhood leukemia in these four Colombian cities. CONCLUSIONS This study offers valuable insights into the incidence trends of childhood leukemia in four major Colombian cities. The analysis revealed stable overall CL incidence rates across varying periods, predominantly influenced by age-related factors and the absence of cohort and period effects. This information is useful for surveillance and planning purposes for CL diagnosis and treatment in Colombia.
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Affiliation(s)
- Natalia Godoy-Casasbuenas
- Ph.D. Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics, Bogotá, Colombia.
| | - Carlos Javier Rincón
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Fabian Gil
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Nelson Arias
- Population-based Cancer Registry of Manizales, Health Promotion and Disease Prevention Research Group (GIPSPE), Instituto de Investigaciones en Salud, Departamento de Salud Pública, Universidad de Caldas, Manizales-Colombia
| | - Claudia Uribe Pérez
- Population-Based Cancer Registry of the Metropolitan Area of Bucaramanga, Bucaramanga, Colombia
| | - María Clara Yépez
- Population-Based Cancer Registry of Pasto, Centro de Estudios en Salud (CESUN), Facultad de Ciencias de la Salud, Universidad de Nariño, Colombia
| | - Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
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Song I, Yoo EH, Jung I, Oh JK, Kim SY. Role of geographic characteristics in the spatial cluster detection of cancer: Evidence in South Korea, 1999-2013. ENVIRONMENTAL RESEARCH 2023; 236:116841. [PMID: 37549782 DOI: 10.1016/j.envres.2023.116841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/04/2023] [Accepted: 08/04/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Identification of high-risk areas of cancer, referred to as spatial clusters, can inform targeted policies for cancer control. Although cancer cluster detection could be affected by various geographic characteristics including sociodemographic and environmental factors which impacts could also vary over time, studies accounting for such influence remain limited. This study aims to assess the role of geographic characteristics in the spatial cluster detection for lung and stomach cancer over an extended period. METHODS We obtained sex-specific age-standardized incidence and mortality rates of lung and stomach cancer as well as geographic characteristics across 233 districts in South Korea for three five-year periods between 1999 and 2013. We classified geographic characteristics of each district into four categories: demography, socioeconomic status, behaviors, and physical environments. Specifically, we quantified physical environments using measures of greenness, concentrations of particulate matter and nitrogen dioxide, and air pollution emissions. Finally, we conducted cluster detection analyses using weighted normal spatial scan statistics with the residuals from multiple regression analyses performed with the four progressive sets of geographic attributes. RESULTS We found that the size of clusters reduced as we progressively adjusted for geographic covariates. Among the four categories, physical environments had the greatest impact on the reduction or disappearance of clusters particularly for lung cancer consistently over time. Whereas older population affected a decrease of lung cancer clusters in the early period, the contribution of education was large in the recent period. The impact was less clear in stomach cancer than lung cancer. CONCLUSION Our findings highlight the importance of geographic characteristics in explaining the existing cancer clusters and identifying new clusters, which jointly provides practical guidance to cancer control.
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Affiliation(s)
- Insang Song
- Department of Geography, University of Oregon, Eugene, OR, 97403, USA
| | - Eun-Hye Yoo
- Department of Geography, The State University of New York at Buffalo, NY, 14261, USA
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center of Korea, Goyang, Gyeonggi-do, 10408, Republic of Korea
| | - Sun-Young Kim
- Department of Cancer AI and Digital Health, Graduate School of Cancer Science and Policy, National Cancer Center of Korea, Goyang, Gyeonggi-do, 10408, Republic of Korea.
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Liu W, Dai K, Wang T, Zhang H, Wu J, Liu W, Fang L. Severe fever with thrombocytopenia syndrome incidence could be associated with ecotone between forest and cultivated land in rural settings of central China. Ticks Tick Borne Dis 2023; 14:102085. [PMID: 36435169 DOI: 10.1016/j.ttbdis.2022.102085] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/21/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS), an emerging tick-borne disease first reported in rural areas of central China, has become a major public health concern in endemic areas. The epidemic dynamic and ecologic factors of SFTS incidence at a village scale remain unclear. Here we analyzed the epidemiological characteristics of SFTS cases in Shangcheng County, the first reported areas of SFTS in China. A retrospective space-time cluster analysis was conducted to identify the dynamics of hotspot areas, and the negative binomial regression model was conducted to examine potential factors contributing to the incidence of SFTS at the village level. A total of 1,219 SFTS cases were reported in Shangcheng County from 2011 to 2020, with a case fatality rate of 12.0%. The median age of patients was 64 years, and 81.7% of patients were over 50 years old. Women accounted for 60.3% of all cases, and the incidence rate was significantly higher than that of men (Pearson χ2 test, P<0.001). Five spatial-temporal clusters were identified, and mostly distributed in the central part of the county. Higher risk of SFTS incidence was shown in villages with higher percentage coverages of forest and tea plantation, and higher goat density. In villages where the ratio of cultivated land area to forest land area was between 0.2 and 1.2, the risk of SFTS incidence increased significantly, with an incidence rate ratio of 1.33 (95% CI: 1.04‒1.72, p = 0.024). Our findings indicated that ecotone between forest and cultivated land might be the most important risk settings for exposure and infection with SFTS virus in endemic areas of central China. Precise identification of risk factors and high-risk areas at a suitable scale is conducive to carrying out targeted measures and improving the surveillance of the disease.
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Affiliation(s)
- Wanshuang Liu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, PR China
| | - Ke Dai
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, PR China
| | - Tao Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, PR China
| | - Haiyang Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, PR China
| | - Jiahong Wu
- School of Basic Medical Sciences, Guizhou Medical University, Guiyang 550025, China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, PR China.
| | - Liqun Fang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, PR China.
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Manrique-Hernández EF, Rojas Díaz MP, Rodriguez-Villamizar LA. Clustering of childhood cancer in Colombia: a nationwide study. F1000Res 2021; 10:86. [PMID: 34249334 PMCID: PMC8261763 DOI: 10.12688/f1000research.27766.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 11/08/2023] Open
Abstract
Background: Childhood cancer is considered one the most important causes of death in children and adolescents, despite having a low incidence in this population. Spatial analysis has been previously used for the study of childhood cancer to study the geographical distribution of leukemias. This study aimed to identify the presence of space-time clusters of childhood of cancer excluding leukemia in Colombia between 2014 and 2017. Methods: All incident cancer cases (excluding leukemia) in children under the age of 15 years that had been confirmed by the National Surveillance System of Childhood Cancer between 2014 and 2017 were included. Kulldorf's circular scan test was used to identify clusters using the municipality of residence as the spatial unit of analysis and the year of diagnosis as the temporal unit of analysis. A sensitivity analysis was conducted with different upper limit parameters for the at-risk population. Results: A total of 2006 cases of non-leukemia childhood cancer were analyzed, distributed in 432 municipalities with a mean annual incidence rate of 44 cases per million children under the age of 15. Central nervous system (CNS) tumors were the most frequent type. Four spatial clusters and two space-time clusters were identified in the central and southwest regions of the country. In the analysis for CNS tumors, a spatial cluster was identified in the central region of the country. Conclusions: The distribution of non-leukemia childhood cancer seems to have a clustered distribution in some Colombian regions that may suggest infectious or environmental factors associated with its incidence.
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Affiliation(s)
- Edgar F. Manrique-Hernández
- Public Health Department, School of Medicine, Universidad Industrial de Santander. Bucaramanga, Santander, Colombia
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Manrique-Hernández EF, Rojas Díaz MP, Rodriguez-Villamizar LA. Clustering of non-leukemia childhood cancer in Colombia: a nationwide study. F1000Res 2021; 10:86. [PMID: 34249334 PMCID: PMC8261763 DOI: 10.12688/f1000research.27766.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Childhood cancer is considered one the most important causes of death in children and adolescents, despite having a low incidence in this population. Spatial analysis has been previously used for the study of childhood cancer to study the geographical distribution of leukemias. This study aimed to identify the presence of space-time clusters of childhood of cancer excluding leukemia in Colombia between 2014 and 2017. Methods: All incident cancer cases (excluding leukemia) in children under the age of 15 years that had been confirmed by the National Surveillance System of Childhood Cancer between 2014 and 2017 were included. Kulldorf's circular scan test was used to identify clusters using the municipality of residence as the spatial unit of analysis and the year of diagnosis as the temporal unit of analysis. A sensitivity analysis was conducted with different upper limit parameters for the at-risk population in the clusters. Results: A total of 2006 cases of non-leukemia childhood cancer were analyzed, distributed in 432 out of 1,122 municipalities with a mean annual incidence rate of 44 cases per million children under the age of 15. Central nervous system (CNS) tumors were the most frequent type. Two space-time clusters were identified in the central and southwest regions of the country. In the analysis for CNS tumors, a spatial cluster was identified in the central region of the country. Conclusions: The distribution of non-leukemia childhood cancer seems to have a clustered distribution in some Colombian regions that may suggest infectious or environmental factors associated with its incidence although heterogeneity in access to diagnosis cannot be discarded.
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Affiliation(s)
- Edgar F. Manrique-Hernández
- Public Health Department, School of Medicine, Universidad Industrial de Santander. Bucaramanga, Santander, Colombia
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Rodriguez-Villamizar LA, Moreno-Corzo FE, Valbuena-Garcia AM, Uribe Pérez CJ, Brome Bohórquez MR, García García HI, Bravo LE, Ortiz Martínez RG, Niederbacher Velásquez J, Osornio-Vargas AR. Childhood Leukemia in Small Geographical Areas and Proximity to Industrial Sources of Air Pollutants in Three Colombian Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7925. [PMID: 33137878 PMCID: PMC7662935 DOI: 10.3390/ijerph17217925] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/24/2020] [Accepted: 10/24/2020] [Indexed: 01/08/2023]
Abstract
Acute leukemia is the most common childhood cancer and has been associated with exposure to environmental carcinogens. This study aimed to identify clusters of acute childhood leukemia (ACL) cases and analyze their relationship with proximity to industrial sources of air pollution in three capital cities in Colombia during 2000-2015. Incident ACL cases were obtained from the population cancer registries for the cities of Bucaramanga, Cali, and Medellín. The inventory of industrial sources of emissions to the air was obtained from the regional environmental authorities and industrial conglomerates were identified. The Kulldorf's circular scan test was used to detect city clusters and to identify clusters around industrial conglomerates. Multivariable spatial modeling assessed the effect of distance and direction from the industrial conglomerates controlling for socioeconomic status. We identified industrials sectors within a buffer of 1 km around industrial conglomerates related to the ACL clusters. Incidence rates showed geographical heterogeneity with low spatial autocorrelation within cities. The spatio-temporal tests identified one cluster in each city. The industries located within 1 km around the ACL clusters identified in the three cities represent different sectors. Exposure to air pollution from industrial sources might be contributing to the incidence of ACL cases in urban settings in Colombia.
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Affiliation(s)
| | - Feisar Enrique Moreno-Corzo
- Public Health Observatory of Santander, Fundación Oftalmológica de Santander, Floridablanca 681003, Colombia; (F.E.M.-C.); (R.G.O.M.)
| | - Ana María Valbuena-Garcia
- Department of Public Health, Universidad Industrial de Santander, Bucaramanga 680002, Colombia;
- Cuenta de Alto Costo, Fondo Colombiano de Enfermedades de Alto Costo, Bogotá 110111, Colombia
| | - Claudia Janeth Uribe Pérez
- Population Based Cancer Registry of the Metropolitan Area of Bucaramanga, Universidad Autónoma de Bucaramanga, Bucaramanga 681003, Colombia;
| | | | | | - Luis Eduardo Bravo
- Population Based Cancer Registry of Cali, Universidad del Valle, Cali 760043, Colombia;
| | - Rafael Gustavo Ortiz Martínez
- Public Health Observatory of Santander, Fundación Oftalmológica de Santander, Floridablanca 681003, Colombia; (F.E.M.-C.); (R.G.O.M.)
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