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Johansson ALV, Kønig SM, Larønningen S, Engholm G, Kroman N, Seppä K, Malila N, Steig BÁ, Gudmundsdóttir EM, Ólafsdóttir EJ, Lundberg FE, Andersson TML, Lambert PC, Lambe M, Pettersson D, Aagnes B, Friis S, Storm H. Have the recent advancements in cancer therapy and survival benefitted patients of all age groups across the Nordic countries? NORDCAN survival analyses 2002-2021. Acta Oncol 2024; 63:179-191. [PMID: 38597666 DOI: 10.2340/1651-226x.2024.35094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/08/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Since the early 2000s, overall and site-specific cancer survival have improved substantially in the Nordic countries. We evaluated whether the improvements have been similar across countries, major cancer types, and age groups. MATERIAL AND METHODS Using population-based data from the five Nordic cancer registries recorded in the NORDCAN database, we included a cohort of 1,525,854 men and 1,378,470 women diagnosed with cancer (except non-melanoma skin cancer) during 2002-2021, and followed for death until 2021. We estimated 5-year relative survival (RS) in 5-year calendar periods, and percentage points (pp) differences in 5-year RS from 2002-2006 until 2017-2021. Separate analyses were performed for eight cancer sites (i.e. colorectum, pancreas, lung, breast, cervix uteri, kidney, prostate, and melanoma of skin). RESULTS Five-year RS improved across nearly all cancer sites in all countries (except Iceland), with absolute differences across age groups ranging from 1 to 21 pp (all cancer sites), 2 to 20 pp (colorectum), -1 to 36 pp (pancreas), 2 to 28 pp (lung), 0 to 9 pp (breast), -11 to 26 pp (cervix uteri), 2 to 44 pp (kidney), -2 to 23 pp (prostate) and -3 to 30 pp (skin melanoma). The oldest patients (80-89 years) exhibited lower survival across all countries and sites, although with varying improvements over time. INTERPRETATION Nordic cancer patients have generally experienced substantial improvements in cancer survival during the last two decades, including major cancer sites and age groups. Although survival has improved over time, older patients remain at a lower cancer survival compared to younger patients.
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Affiliation(s)
- Anna L V Johansson
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Simon M Kønig
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Siri Larønningen
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Gerda Engholm
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Niels Kroman
- Department Breast Surgery, Copenhagen University Hospital (Herlev/Gentofte), Copenhagen, Denmark
| | - Karri Seppä
- Finnish Cancer Registry, Helsinki, Finland; Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland
| | - Bjarni Á Steig
- National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | | | | | - Frida E Lundberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Therese M-L Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul C Lambert
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Biostatistics Research Group, Department of Health Sciences, University of Leicester, UK
| | - Mats Lambe
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Regional Cancer Center Mid-Sweden, Uppsala, Sweden
| | - David Pettersson
- Swedish Cancer Registry, National Board of Health and Welfare, Stockholm, Sweden
| | - Bjarte Aagnes
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Søren Friis
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Hans Storm
- Danish Cancer Society, Copenhagen, Denmark
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Ding L, Zhang C, Wang K, Zhang Y, Wu C, Xia W, Li S, Li W, Wang J. A machine learning-based model for predicting the risk of early-stage inguinal lymph node metastases in patients with squamous cell carcinoma of the penis. Front Surg 2023; 10:1095545. [PMID: 37009612 PMCID: PMC10063794 DOI: 10.3389/fsurg.2023.1095545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/07/2023] [Indexed: 03/19/2023] Open
Abstract
ObjectiveInguinal lymph node metastasis (ILNM) is significantly associated with poor prognosis in patients with squamous cell carcinoma of the penis (SCCP). Patient prognosis could be improved if the probability of ILNM incidence could be accurately predicted at an early stage. We developed a predictive model based on machine learning combined with big data to achieve this.MethodsData of patients diagnosed with SCCP were obtained from the Surveillance, Epidemiology, and End Results Program Research Data. By combing variables that represented the patients' clinical characteristics, we applied five machine learning algorithms to create predictive models based on logistic regression, eXtreme Gradient Boosting, Random Forest, Support Vector Machine, and k-Nearest Neighbor. Model performance was evaluated by ten-fold cross-validation receiver operating characteristic curves, which were used to calculate the area under the curve of the five models for predictive accuracy. Decision curve analysis was conducted to estimate the clinical utility of the models. An external validation cohort of 74 SCCP patients was selected from the Affiliated Hospital of Xuzhou Medical University (February 2008 to March 2021).ResultsA total of 1,056 patients with SCCP from the SEER database were enrolled as the training cohort, of which 164 (15.5%) developed early-stage ILNM. In the external validation cohort, 16.2% of patients developed early-stage ILNM. Multivariate logistic regression showed that tumor grade, inguinal lymph node dissection, radiotherapy, and chemotherapy were independent predictors of early-stage ILNM risk. The model based on the eXtreme Gradient Boosting algorithm showed stable and efficient prediction performance in both the training and external validation groups.ConclusionThe ML model based on the XGB algorithm has high predictive effectiveness and may be used to predict early-stage ILNM risk in SCCP patients. Therefore, it may show promise in clinical decision-making.
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Affiliation(s)
| | | | | | | | | | | | | | - Wang Li
- Correspondence: Wang Li Junqi Wang
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3
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Deng X, Liu Y, Zhan X, Chen T, Jiang M, Jiang X, Chen L, Fu B. Trends in Incidence, Mortality, and Survival of Penile Cancer in the United States: A Population-Based Study. Front Oncol 2022; 12:891623. [PMID: 35785206 PMCID: PMC9248743 DOI: 10.3389/fonc.2022.891623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeThe aim of this study is to investigate the trends in incidence and mortality, and explore any change in survival of penile cancer in the United States.MethodsWe obtained data from the Surveillance, Epidemiology, and End Results (SEER) database (2000–2018) utilizing the SEER Stat software. The joinpoint regression was used to analyze the secular trend of incidence and incidence-based mortality (IBM) stratified by age, race, and summary stage. The 5-year relative survival rate was also calculated.ResultThe age-adjusted rates of penile cancer patients were 0.38 (0.37–0.39) and 0.21 (0.2–0.21) for overall incidence and IBM, respectively. The 5-year relative survival rates were 67.7%, 66.99%, and 65.67% for the calendar periods of 2000–2004, 2005–2009, and 2010–2014, respectively. No significant changes in incidence by era were observed from 2000 to 2018 [annual percentage change (APC) = 0.5%, p = 0.064]. The IBM rate of penile cancer showed an initial significant increase from 2000 to 2002 (APC = 78.6%, 95% CI, −1.7–224.6) followed by a deceleration rate of 4.6% (95% CI, 3.9–5.3) during 2002 to 2018. No significant improvement in 5-year relative survival was observed. The trends by age, race, and summary stage in incidence and IBM were significantly different.ConclusionThis study, using population-level data from the SEER database, showed an increasing trend in IBM and no significant improvement in the 5-year relative survival rate. Meanwhile, the incidence of penile cancer exhibited a relatively stable trend during the study period. These results might be due to the lack of significant progress in the treatment and management of penile cancer patients in the United States in recent decades. More efforts, like increasing awareness among the general population and doctors, and centralized management, might be needed in the future to improve the survival of this rare disease.
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Affiliation(s)
- Xinxi Deng
- Department of Urology, Jiu Jiang No.1 People’s Hospital, Jiujiang, China
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yang Liu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiangpeng Zhan
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Chen
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ming Jiang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xinhao Jiang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Luyao Chen
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Bin Fu, ; Luyao Chen,
| | - Bin Fu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Bin Fu, ; Luyao Chen,
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Olesen TB, Sand FL, Aalborg GL, Munk C, Kjaer SK. Incidence of penile intraepithelial neoplasia and incidence and survival of penile cancer in Denmark, 1997 to 2018. Cancer Causes Control 2021; 33:117-123. [PMID: 34698994 DOI: 10.1007/s10552-021-01510-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 10/14/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Squamous cell carcinoma (SCC) of the penis is rare. Some studies have suggested that the incidence is increasing but the available literature is equivocal. We examined the incidence of high-grade penile intraepithelial neoplasia (PeIN), the incidence and 5-year relative survival as well as mortality of penile SCC in Denmark over the latest 20 years. METHODS New cases of high-grade PeIN and penile cancer were identified from high-quality nationwide registries. Age-standardized (World) incidence rates per 100,000 person-years and average annual percentage change (AAPC) were estimated. For penile SCC, 5-year relative survival was calculated, and Cox regression was used to examine the effect of selected characteristics on mortality. RESULTS Altogether, 1,070 new cases of high-grade PeIN were diagnosed (1997-2018) and the incidence increased from 0.87 to 1.84 per 100,000 person-years from 1997-1998 to 2017-2018 (AAPC = 4.73; 95% CI: 3.54-5.94). We identified 1,216 penile cancer cases (1997-2018) (95.7% SCC). The incidence of penile SCC increased slightly from 0.85 per 100,000 person-years in 1997-1998 to 1.13 per 100,000 person-years in 2017-2018 (AAPC = 1.01; 95% CI: 0.24-1.79). The 5-year relative survival of penile SCC did not change substantially, whereas the mortality tended to decrease. CONCLUSION Penile SCC is increasing slightly in Denmark, while a pronounced increase in the incidence of high-grade PeIN is seen. The 5-year relative survival from penile cancer was relatively stable over time. Increasing exposure to HPV infection at the population level may have contributed to the observed increase in PeIN and penile SCC. Awareness of HPV may also have contributed to the increased detection of PeIN.
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Affiliation(s)
- Tina Bech Olesen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen, Denmark.
| | - Freja L Sand
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen, Denmark
| | - Gitte L Aalborg
- Unit of Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Christian Munk
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Vallo S, Kloft J, Jones J, John P, Khoder W, Mahmud W, Mani J. Evaluation of Testicular Self Examination and Testicular Partner Examination in Medical versus Non-Medical Students. Curr Urol 2020; 14:92-97. [PMID: 32774234 DOI: 10.1159/000499253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/25/2019] [Indexed: 01/07/2023] Open
Abstract
Objectives Although testicular cancer (TC) is the most common tumor in young men in Western countries, there is no official cancer detection/screening program for young men in Germany. The most important TC detection tool is self-examination of the testis. Hypothetically medical students may have a diagnosis lead time and detection superiority. This study was designed to analyze whether medical students have a possible knowledge advantage over students of other faculties concerning TC and to compare male and female cancer screening demeanor and mentality. Methods Male and female students of various faculties at the Goethe University Frankfurt/Main, Germany were invited to participate in this internet-based anonymous questionnaire with questions about TC awareness/knowledge, testicular (self) examination, and cancer screening behavior. Results In total 1,049 students (329 medical and 716 non-medical students) completed the questionnaire. In general, medical students had a significantly higher TC knowledge, especially in the more advanced stages of their medical studies (year 3-6). About 50% of medical students had knowledge of TC whereas only 21.3% of non-medical students knew about the disease (p < 0.01). In addition, medical students conducted scrotal examinations more frequently (34.7%) than non-medical students (18.8%). Conclusion The knowledge about TC is low among students. In general, medical students are more aware of TC and perform more frequent testicular examinations compared to non-medical students. Female TC knowledge rises in the clinical part of studies to the same level as their male counterparts, with the result of more testicular partner examinations.
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Affiliation(s)
- Stefan Vallo
- Department of Urology, Hochtaunus-Kliniken, Bad Homburg, Germany
| | | | - Jon Jones
- Department of Urology, Hochtaunus-Kliniken, Bad Homburg, Germany
| | - Patricia John
- Department of Urology, University Hospital Cologne, Cologne, Germany
| | - Wael Khoder
- Department of Urology, University Hospital Freiburg, Freiburg, Germany
| | - Walid Mahmud
- Department of Urology, Hochtaunus-Kliniken, Bad Homburg, Germany
| | - Jens Mani
- University of Frankfurt, Frankfurt, Germany.,Urogate, Frankfurt, Germany
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Li Y, Lu Q, Wang Y, Ma S. Racial differences in testicular cancer in the United States: descriptive epidemiology. BMC Cancer 2020; 20:284. [PMID: 32252689 PMCID: PMC7137202 DOI: 10.1186/s12885-020-06789-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 03/26/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Testicular cancer (TC) is the most common malignancy in young adult men, and in many countries the incidence rates of testicular cancer have been increasing since the middle of the twentieth century. Since disease presentation and tumor progression patterns are often heterogeneous across racial groups, there may be important racial differences in recent TC trends. METHODS In this study, Surveillance, Epidemiology, and End Results (SEER) data on TC patients diagnosed between 1973 and 2015 were analyzed, including the following racial/ethnic groups: non-Hispanic whites (NHW), Hispanic whites (HW), blacks, and Asians and Pacific Islanders (API). Patient characteristics, age-adjusted incidence rates, and survival were compared across racial groups. A multivariate Cox model was used to analyze the survival data of TC patients, in order to evaluate racial differences across several relevant factors, including marital status, age group, histologic type, treatment, stage, and tumor location. RESULTS NHWs had the highest incidence rates, followed by blacks, HWs, and APIs. There were significant survival differences among the racial groups, with NHWs having the highest survival rates and blacks having the lowest. CONCLUSION An analysis of SEER data showed that racial differences existed among TC patients in the United States with respect to patient characteristics, incidence, and survival. The results can be useful to stakeholders interested in reducing the burden of TC morbidity and mortality.
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Affiliation(s)
- Yang Li
- Center for Applied Statistics, Renmin University of China, Beijing, China
- School of Statistics, Renmin University of China, Beijing, China
| | - Qi Lu
- School of Statistics, Renmin University of China, Beijing, China
| | - Yu Wang
- Center for Applied Statistics, Renmin University of China, Beijing, China.
- School of Statistics, Renmin University of China, Beijing, China.
| | - Shuangge Ma
- School of Statistics, Renmin University of China, Beijing, China
- School of Public Health, Yale University, New Haven, Connecticut, USA
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Yang J, Pan Z, He Y, Zhao F, Feng X, Liu Q, Lyu J. Competing-risks model for predicting the prognosis of penile cancer based on the SEER database. Cancer Med 2019; 8:7881-7889. [PMID: 31657120 PMCID: PMC6912058 DOI: 10.1002/cam4.2649] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 07/16/2019] [Accepted: 10/10/2019] [Indexed: 11/26/2022] Open
Abstract
Objectives This study performed a competing‐risks analysis using data from the SEER database on penile cancer patients with the aim of identifying more accurate prognostic factors. Methods Data on patients with penile cancer were extracted from the SEER database. A univariate analysis used the cumulative incidence function and Gray's test, while multivariate analysis was performed using the Fine‐Gray model. Cumulative hazards were compared with a competing‐risks model constructed using Kaplan‐Meier estimation. Results The multivariate Fine‐Gray analysis indicated that being black (HR = 1.51, 95%CI: 1.10‐2.07, P = .01), AJCC stage II (HR = 1.94, 95%CI: 1.36‐2.77, P < .001), AJCC stage III (HR = 1.98, 95%CI: 1.34‐2.91, P < .001), tumor size > 5 cm (HR = 2.23, 95%CI: 1.33‐3.72, P < .05), and TNM stages N1 (HR = 2.49, 95%CI: 1.71‐3.61, P < .001), N2 (HR = 3.25, 95%CI: 2.18‐4.84, P < .001), N3 (HR = 5.05, 95%CI: 2.69‐9.50, P < .001), and M1 (HR = 2.21, 95%CI: 1.28‐3.84, P < .05) were statistically significant. The results obtained using multivariate Cox regression were different, while Kaplan‐Meier curve analysis led to an overestimation of the cumulative risk of the patient. Conclusions This study established a competing‐risks analysis model for the first time based on the SEER database for the risk assessment of penile cancer patients. The results may help clinicians to better understand penile cancer and provide these patients with more appropriate support.
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Affiliation(s)
- Jin Yang
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Zhenyu Pan
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.,Department of Pharmacy, The Affiliated Children Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yujing He
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Fanfan Zhao
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Xiaojie Feng
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Qingqing Liu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 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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Nicolai N, Biasoni D, Catanzaro MA, Colecchia M, Trama A, Hackl M, Eycken EV, Henau K, Dimitrova N, Sekerija M, Dušek L, Mägi M, Malila N, Leinonen M, Velten M, Troussard X, Bouvier V, Guizard AV, Bouvier AM, Arveux P, Maynadié M, Woronoff AS, Robaszkiewic M, Baldi I, Monnereau A, Tretarre B, Colonna M, Molinié F, Bara S, Schvartz C, Lapôtre-Ledoux B, Grosclaude P, Stabenow R, Luttmann S, Nennecke A, Engel J, Schubert-Fritschle G, Heidrich J, Holleczek B, Jónasson JG, Clough-Gorr K, Comber H, Mazzoleni G, Giacomin A, Sutera Sardo A, Barchielli A, Serraino D, De Angelis R, Mallone S, Tavilla A, Pierannunzio D, Rossi S, Santaquilani M, Knijn A, Pannozzo F, Gennaro V, Benfatto L, Ricci P, Autelitano M, Spagnoli G, Fusco M, Usala M, Vitale F, Michiara M, Tumino R, Mangone L, Falcini F, Ferretti S, Filiberti RA, Marani E, Iannelli A, Sensi F, Piffer S, Gentilini M, Madeddu A, Ziino A, Maspero S, Candela P, Stracci F, Tagliabue G, Rugge M, Trama A, Gatta G, Botta L, Capocaccia R, Pildava S, Smailyte G, Calleja N, Johannesen TB, Rachtan J, Góźdź S, Błaszczyk J, Kępska K, de Lacerda GF, Bento MJ, Miranda A, Diba CS, Almar E, Larrañaga N, de Munain AL, Torrella-Ramos A, Díaz García JM, Marcos-Gragera R, Sanchez MJ, Navarro C, Salmeron D, Moreno-Iribas C, Galceran J, Carulla M, Mousavi M, Bouchardy C, M. Ess S, Bordoni A, Konzelmann I, Rashbass J, Gavin A, Brewster DH, Huws DW, Visser O, Bielska-Lasota M, Primic-Zakelj M, Kunkler I, Benhamou E. Testicular germ-cell tumours and penile squamous cell carcinoma: Appropriate management makes the difference. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Hansen BT, Orumaa M, Lie AK, Brennhovd B, Nygård M. Trends in incidence, mortality and survival of penile squamous cell carcinoma in Norway 1956-2015. Int J Cancer 2018; 142:1586-1593. [PMID: 29205336 PMCID: PMC5838782 DOI: 10.1002/ijc.31194] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/20/2017] [Accepted: 11/23/2017] [Indexed: 01/23/2023]
Abstract
We examine trends in incidence, mortality and survival of penile squamous cell carcinoma (SCC) in Norway over 60 years. Data on all cases of penile cancer diagnosed in Norway during 1956-2015 were obtained from the Cancer Registry of Norway. Trends in age-standardized rates of penile SCC incidence, mortality and 5-year relative survival were assessed by the annual percentage change statistic and joinpoint regression. A total of 1,596 penile cancer cases were diagnosed during 1956-2015, among which 1,474 (92.4%) were SCC. During 2011-2015, the age-standardized incidence and mortality of penile SCC were 0.91 (95% confidence interval (CI): 0.78; 1.05) and 0.50 (0.42; 0.60) per 100,000, respectively, and the 5-year relative survival was 61.6% (41.9; 76.4). The incidence of SCC increased during 1956-2015, with an average annual percentage change (AAPC) of 0.80% (0.46; 1.15). The increase was strongest among men diagnosed at a relatively early age (age<=64 years; AAPC: 1.47% (0.90; 2.05)). Mortality also increased over the study period (AAPC: 0.47% (0.10; 0.85)), whereas 5-year relative survival did not change (AAPC: 0.08% (-0.19; 0.36)). We conclude that the incidence of penile SCC has increased at a moderate and constant rate during 1956-2015, and that the most consistent increase occurred among younger men. Mortality also increased during the study period. However, survival did not change, thus changes in diagnostics and treatment had little impact on survival from penile SCC. Since a substantial proportion of penile SCC is caused by human papillomavirus (HPV), the incidence increase may in part be attributed to increased exposure to HPV in the population.
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Affiliation(s)
- Bo T. Hansen
- Department of ResearchCancer Registry of NorwayOsloNorway
| | - Madleen Orumaa
- Department of ResearchCancer Registry of NorwayOsloNorway
| | - A. Kathrine Lie
- Section for Pathology, Center for Laboratory MedicineØstfold Hospital TrustGrålumNorway
| | - Bjørn Brennhovd
- Division of Cancer Medicine, Transplantation and SurgeryOslo University HospitalOsloNorway
| | - Mari Nygård
- Department of ResearchCancer Registry of NorwayOsloNorway
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Chipollini J, Tang DH, Manimala N, Gilbert SM, Pow-Sang JM, Sexton WJ, Poch MA, Spiess PE. Evaluating the accuracy of intraoperative frozen section during inguinal lymph node dissection in penile cancer. Urol Oncol 2017; 36:14.e1-14.e5. [PMID: 29032883 DOI: 10.1016/j.urolonc.2017.08.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/02/2017] [Accepted: 08/21/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Inguinal lymph node dissection is an integral part in the management of invasive penile tumors with intraoperative assessment often aiding decision-making during dissection. In this study, we evaluate the diagnostic value of intraoperative frozen section (FS) and analyze clinicopathologic factors that affect its accuracy. MATERIAL AND METHODS We, retrospectively, reviewed 84 patients with squamous cell carcinoma of the penis who underwent inguinal lymph node dissection at our institution. Intraoperative FS from the superficial inguinal nodes was available in 65 patients and compared with correspondent permanent sections (pathologic node staging [pN]). Sensitivity and specificity were calculated and factors associated with a false negative event were analyzed using logistic regression. RESULTS The total positive node rate was 60% (39/65). Of 39 pN+ cases, 10 (25.6%) had false-negative FS, whereas the remaining 29 were concordant intraoperatively. Sensitivity and specificity were 0.74 and 1, respectively. On univariable analysis, higher body mass index was associated with a false negative event although there was no association with age, receipt of neoadjuvant therapy, or clinical node stage. CONCLUSION Intraoperative FS is highly specific and moderately sensitive for the detection of positive superficial inguinal lymph nodes in penile cancer. Its use can help guide intraoperative surgical planning while limiting its reliance for patients with higher body mass index.
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Affiliation(s)
- Juan Chipollini
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL.
| | - Dominic H Tang
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Neil Manimala
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Scott M Gilbert
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Julio M Pow-Sang
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Wade J Sexton
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Michael A Poch
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
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12
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Daubisse-Marliac L, Colonna M, Trétarre B, Defossez G, Molinié F, Jéhannin-Ligier K, Marrer E, Grosclaude P. Long-term trends in incidence and survival of penile cancer in France. Cancer Epidemiol 2017; 50:125-131. [PMID: 28898817 DOI: 10.1016/j.canep.2017.08.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/19/2017] [Accepted: 08/22/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Penile cancer is rare, and few population-based studies have described changes in time trend. This study aims to determine whether there has been an evolution in incidence and survival of penile cancer over time in France. METHODS Rates of age world-standardized incidence (ASRW) and net survival (NS) between 1989 and 2011 were calculated using data from 16 French cancer registries. Time trend incidence and survival analysis were confined to the eight registries operating throughout the full period. Log-linear Poisson regression analysis was used to estimate the average annual percentage change (AAPC) in incidence rates. The incidence rate for the most recent period was also calculated from all 16 cancer registries operating during 2009-2011. Human papillomavirus (HPV) exposure was deduced from the morphological code. NS was estimated using the Pohar-Perme estimator of the net cumulative rate. RESULTS No significant change in incidence was observed between 1989 and 2011 (AAPC: 0.08%; 95%CI: -1.01%; +1.17%). The incidence increased with age. The ASRW in 16 registries operating in 2009-2011 was 0.59 per 100,000 (95%CI: 0.50-0.68). The proportion of cases potentially linked to HPV was nearly 11% and did not change significantly over time. NS decreased with age but did not change over time (around 65% at 5 years). CONCLUSION Penile cancer remains rare in France, but survival is still low - probably because of delays in diagnosis and limited improvements in care. International clinical trials are needed to develop care recommendations based on an adequate level of evidence.
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Affiliation(s)
- Laetitia Daubisse-Marliac
- Claudius Regaud Institute, Regional Cancer Center, IUCT-O, Tarn Cancer Registry, Toulouse, F-31059, France; CHU, Toulouse F-31000, France; LEASP, UMR 1027 Inserm, Toulouse III University, F-31000, France; FRANCIM Network, Toulouse, F-31073, France.
| | - Marc Colonna
- FRANCIM Network, Toulouse, F-31073, France; Isère Cancer Registry, Grenoble, F-38043, France.
| | - Brigitte Trétarre
- FRANCIM Network, Toulouse, F-31073, France; Hérault Cancer Registry, Regional Cancer Center (ICM), Montpellier, F-34000, France.
| | - Gautier Defossez
- FRANCIM Network, Toulouse, F-31073, France; Poitou-Charentes Cancer Registry, CHU Poitiers, F-86000, France.
| | - Florence Molinié
- FRANCIM Network, Toulouse, F-31073, France; Loire-Atlantique & Vendée Cancer Registry, CHU Nantes, F-44000, France.
| | - Karine Jéhannin-Ligier
- FRANCIM Network, Toulouse, F-31073, France; Cancer Registry of Lille, C2RC, Lille, F-59000, France.
| | - Emilie Marrer
- FRANCIM Network, Toulouse, F-31073, France; Haut-Rhin Cancer Registry, ARER 68 Mulhouse, F-68000, France.
| | - Pascale Grosclaude
- Claudius Regaud Institute, Regional Cancer Center, IUCT-O, Tarn Cancer Registry, Toulouse, F-31059, France; LEASP, UMR 1027 Inserm, Toulouse III University, F-31000, France; FRANCIM Network, Toulouse, F-31073, France.
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13
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Chipollini J, Tang DH, Sharma P, Baumgarten AS, Spiess PE. Patterns of Regional Lymphadenectomy for Clinically Node-negative Patients With Penile Carcinoma: Analysis From the National Cancer Database From 1998 to 2012. Clin Genitourin Cancer 2017; 15:670-677.e1. [PMID: 28522287 DOI: 10.1016/j.clgc.2017.04.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE Evidence supports upfront regional lymphadenectomy (rND) when primary penile tumors exhibit high-risk features and negative inguinal adenopathy (cN0). We sought to analyze trends in the utilization of early rND as well as assess factors associated with its use and survival outcomes using a nationwide cancer registry database. PATIENT AND METHODS The National Cancer Database was queried for patients with clinically nonmetastatic penile carcinoma and available nodal status who underwent rND from 1998 to 2012. Temporal trends in the utilization of early rND for those with cN0 disease were analyzed, and a multivariable logistic regression model was used to identify predictors for receiving rND. Survival analysis based on rND status was performed using the Kaplan-Meier method and Cox proportional hazard regression. RESULTS From 1919 patients with available clinicopathologic variables, performance of early rND was documented in 377 (19.6%) patients with an increase in utilization over time (P = .001). The increase was driven by academic and comprehensive cancer programs compared with community programs (P < .001). Positive predictors were treatment facility, clinical tumor stage, and grade (all P < .05). African American patients (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.33-0.86; P = .01) and those aged > 75 years (OR, 0.42; 95% CI, 0.26-0.68; P < .001) were significantly less likely to receive rND. Early rND was associated with improved overall survival (hazard ratio [HR], 0.67; 95% CI, 0.52-0.87; P = .003). CONCLUSION There was increased use of early lymphadenectomy for patients with cN0 penile cancer driven by comprehensive and academic cancer programs. The study demonstrated demographic and socioeconomic differences that can help identify barriers to care for patients with penile cancer in the United States.
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Affiliation(s)
- Juan Chipollini
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Dominic H Tang
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Pranav Sharma
- Department of Urology, Texas Tech University Health Science Center, Lubbock, TX
| | - Adam S Baumgarten
- Department of Urology, University of South Florida, Morsani College of Medicine, Tampa, FL
| | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL.
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Antoni S, Soerjomataram I, Møller B, Bray F, Ferlay J. An assessment of GLOBOCAN methods for deriving national estimates of cancer incidence. Bull World Health Organ 2016; 94:174-84. [PMID: 26966328 PMCID: PMC4773935 DOI: 10.2471/blt.15.164384] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 11/25/2015] [Accepted: 12/04/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To assess the validity of the GLOBOCAN methods for deriving national estimates of cancer incidence. METHODS We obtained incidence and mortality data from Norway by region, year of diagnosis, cancer site, sex and 5-year age group for the period 1983-2012 from the NORDCAN database. Estimates for the year 2010 were derived using nine different methods from GLOBOCAN. These included the projection of national historical rates, the use of regional proxies and the combination of national mortality data with mortality to incidence ratios or relative survival proportions. We then compared the national estimates with recorded cancer incidence data. FINDINGS Differences between the estimates derived using different methods varied by cancer site and sex. Methods based on projections performed better where major changes in recent trends were absent. Methods based on mortality data performed less well for cancers associated with small numbers of deaths and for cancers detectable by screening. In countries with longstanding cancer registries of high quality, regional-based, or trends-based incidence estimates perform reasonably well in comparison with recorded incidence. CONCLUSION Although the performance of the GLOBOCAN methods varies by cancer site and sex in this study, the results emphasize a need for more high-quality population-based cancer registries - either regional or, where practical and feasible, national registries - to describe cancer patterns and trends for planning cancer control priorities.
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Affiliation(s)
- Sebastien Antoni
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon, Cedex 08, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon, Cedex 08, France
| | | | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon, Cedex 08, France
| | - Jacques Ferlay
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon, Cedex 08, France
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15
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Trama A, Foschi R, Larrañaga N, Sant M, Fuentes-Raspall R, Serraino D, Tavilla A, Van Eycken L, Nicolai N, Hackl M, Zielonke N, Oberaigner W, Van Eycken E, Henau K, Valerianova Z, Dimitrova N, Sekerija M, Zvolský M, Dušek L, Storm H, Engholm G, Mägi M, Aareleid T, Malila N, Seppä K, Velten M, Troussard X, Bouvier V, Launoy G, Guizard A, Faivre J, Bouvier A, Arveux P, Maynadié M, Woronoff A, Robaszkiewicz M, Baldi I, Monnereau A, Tretarre B, Bossard N, Belot A, Colonna M, Molinié F, Bara S, Schvartz C, Lapôtre-Ledoux B, Grosclaude P, Meyer M, Stabenow R, Luttmann S, Eberle A, Brenner H, Nennecke A, Engel J, Schubert-Fritschle G, Kieschke J, Heidrich J, Holleczek B, Katalinic A, Jónasson J, Tryggvadóttir L, Comber H, Mazzoleni G, Bulatko A, Buzzoni C, Giacomin A, Sutera Sardo A, Mancuso P, Ferretti S, Crocetti E, Caldarella A, Gatta G, Sant M, Amash H, Amati C, Baili P, Berrino F, Bonfarnuzzo S, Botta L, Di Salvo F, Foschi R, Margutti C, Meneghini E, Minicozzi P, Trama A, Serraino D, Dal Maso L, De Angelis R, Caldora M, Capocaccia R, Carrani E, Francisci S, Mallone S, Pierannunzio D, Roazzi P, Rossi S, Santaquilani M, Tavilla A, Pannozzo F, Busco S, Bonelli L, Vercelli M, Gennaro V, Ricci P, Autelitano M, Randi G, Ponz De Leon M, Marchesi C, Cirilli C, Fusco M, F. Vitale M, Usala M, Traina A, Staiti R, Vitale F, Ravazzolo B, Michiara M, Tumino R, Giorgi Rossi P, Di Felice E, Falcini F, Iannelli A, Sechi O, Cesaraccio R, Piffer S, Madeddu A, Tisano F, Maspero S, Fanetti A, Zanetti R, Rosso S, Candela P, Scuderi T, Stracci F, Bianconi F, Tagliabue G, Contiero P, Dei Tos A, Guzzinati S, Pildava S, Smailyte G, Calleja N, Agius D, Johannesen T, Rachtan J, Gózdz S, Mezyk R, Blaszczyk J, Bebenek M, Bielska-Lasota M, Forjaz de Lacerda G, Bento M, Castro C, Miranda A, Mayer-da-Silva A, Nicula F, Coza D, Safaei Diba C, Primic-Zakelj M, Almar E, Ramírez C, Errezola M, Bidaurrazaga J, Torrella-Ramos A, Díaz García J, Jimenez-Chillaron R, Marcos-Gragera R, Izquierdo Font A, J. Sanchez M, Chang D, Navarro C, Chirlaque M, Moreno-Iribas C, Ardanaz E, Galceran J, Carulla M, Lambe M, Khan S, Mousavi M, Bouchardy C, Usel M, M. Ess S, Frick H, Lorez M, Ess S, Herrmann C, Bordoni A, Spitale A, Konzelmann I, Visser O, Verhoeven R, Coleman M, Allemani C, Rachet B, Verne J, Easey N, Lawrence G, Moran T, Rashbass J, Roche M, Wilkinson J, Gavin A, Donnelly C, Brewster D, Huws D, White C, Otter R. Survival of male genital cancers (prostate, testis and penis) in Europe 1999–2007: Results from the EUROCARE-5 study. Eur J Cancer 2015; 51:2206-2216. [DOI: 10.1016/j.ejca.2015.07.027] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/09/2015] [Accepted: 07/20/2015] [Indexed: 11/26/2022]
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16
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Ingimarsdóttir IJ, Rusch E, Engholm G, Storm HH, Brasso K. Quality assessment of prostate cancer reports to the Danish Cancer Registry. Acta Oncol 2015; 55:24-9. [PMID: 26083679 DOI: 10.3109/0284186x.2015.1054948] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Danish Cancer Registry (DCR) is the oldest nationwide population-based cancer registry in the Nordic countries. At the time of the study the DCR recorded date of diagnosis, tumor stage and initial treatment. The validity of the clinical information reported to the DCR has never been analyzed. MATERIAL AND METHODS Patients diagnosed with prostate cancer from 1 May to 31 December 1997 and living in eight Danish counties were identified through the DCR. Clinical data was retrieved from hospital records where date of diagnosis, stage at diagnosis and treatment received were registered. RESULTS The mean age at diagnosis was 74.6 years (s.d. 8.6 years). Diagnosis was verified histologically for 87% of cases. Overall 95% of the patients had a difference less than three months between the reported date of diagnosis and the date found in hospital records. Correction of dates of diagnosis had no impact on survival. Hospital records identified 86 patients with T1-2 disease without distant metastases (M0), but only 56 of these patients (65%) were reported to the DCR as having localized disease. According to hospital records a total of 242 patients were confirmed having distant metastases (M1) at diagnosis but only 139 of these cases (57%) were reported to the DCR as such. Considerable "over reporting" of curative treatment was observed. CONCLUSION The DCR has been shown to be reliable in terms of new cases being reported. For the majority of cases there were insignificant differences concerning the date of diagnosis. However, the DCR information on stage and treatment was found to be inaccurate. Since 2004 the DCR registration process, including staging according to the TNM classification, has been carried out electronically from several registers. Future comparison between cohorts of different time intervals or international comparison should be interpreted with caution when clinical information is included.
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Affiliation(s)
- Inga Jóna Ingimarsdóttir
- Department of Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark
- Landspítali University Hospital, University of Iceland, Reykjavík, Iceland
| | - Ea Rusch
- Department of Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark
| | - Gerda Engholm
- Department of Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark
| | - Hans H. Storm
- Department of Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark
| | - Klaus Brasso
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, University of Copenhagen, Denmark
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17
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Håkonsen LB, Ernst A, Ramlau-Hansen CH. Maternal cigarette smoking during pregnancy and reproductive health in children: a review of epidemiological studies. Asian J Androl 2014; 16:39-49. [PMID: 24369132 PMCID: PMC3901880 DOI: 10.4103/1008-682x.122351] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Maternal cigarette smoking may affect the intrauterine hormonal environment during pregnancy and this early fetal exposure may have detrimental effects on the future trajectory of reproductive health. In this review, we discuss the epidemiological literature on the association between prenatal exposure to maternal cigarette smoking and several aspects of reproductive health. The literature points towards an increased risk of the urogenital malformation cryptorchidism, but a potential protective effect on the risk of hypospadias in sons following prenatal cigarette smoking exposure. Studies on sexual maturation find a tendency towards accelerated pubertal development in exposed boys and girls. In adult life, prenatally exposed men have impaired semen quality compared with unexposed individuals, but an influence on fecundability, that is, the biological ability to reproduce, is less evident. We found no evidence to support an association between prenatal cigarette smoking exposure and testicular cancer. Among adult daughters, research is sparse and inconsistent, but exposure to cigarette smoking in utero may decrease fecundability. In conclusion, prenatal exposure to cigarette smoking may cause some long-term adverse effects on the reproductive health.
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Affiliation(s)
- Linn Berger Håkonsen
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
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18
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Hjertholm P, Fenger-Grøn M, Vestergaard M, Christensen MB, Borre M, Møller H, Vedsted P. Variation in general practice prostate-specific antigen testing and prostate cancer outcomes: an ecological study. Int J Cancer 2014; 136:435-42. [PMID: 24905402 DOI: 10.1002/ijc.29008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/29/2014] [Accepted: 05/20/2014] [Indexed: 11/05/2022]
Abstract
Knowledge is sparse about the consequences of variation in prostate-specific antigen (PSA) testing rates in general practice. This study investigated associations between PSA testing and prostate cancer- related outcomes in Danish general practice, where screening for prostate cancer is not recommended. National registers were used to divide general practices into four groups based on their adjusted PSA test rate 2004-2009. We analysed associations between PSA test rate and prostate cancer-related outcomes using Poisson regression adjusted for potential confounders. We included 368 general practices, 303,098 men and 4,199 incident prostate cancers. Men in the highest testing quartile of practices compared to men in the lowest quartile had increased risk of trans-rectal ultrasound (incidence rate ratio (IRR): 1.20, 95% CI, 0.95-1.51), biopsy (IRR: 1.76, 95% CI, 1.54-2.02), and getting a prostate cancer diagnosis (IRR: 1.37, 95% CI, 1.23-1.52). More were diagnosed with local stage disease (IRR: 1.61, 95% CI, 1.37-1.89) with no differences regarding regional or distant stage. The IRR for prostatectomy was 2.25 (95% CI, 1.72-2.94) and 1.28 (95% CI, 1.02-1.62) for radiotherapy. No differences in prostate cancer or overall mortality were found between the groups. These results show that the highest PSA testing general practices may not reduce prostate cancer mortality but increase the downstream use of diagnostic and surgical procedures with potentially harmful side effects.
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Affiliation(s)
- Peter Hjertholm
- Research Center for Cancer Diagnosis in Primary Care, Aarhus University, Aarhus C, Denmark; Research Unit for General Practice, Aarhus University, Aarhus C, Denmark; Section for General Medical Practice, Aarhus University, Aarhus C, Denmark
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19
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Bresse X, Goergen C, Prager B, Joura E. Universal vaccination with the quadrivalent HPV vaccine in Austria: impact on virus circulation, public health and cost–effectiveness analysis. Expert Rev Pharmacoecon Outcomes Res 2014; 14:269-81. [DOI: 10.1586/14737167.2014.881253] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Nguyen-Nielsen M, Nørgaard M, Jacobsen JB, Borre M, Thomsen RW, Søgaard M. Comorbidity and survival of Danish prostate cancer patients from 2000-2011: a population-based cohort study. Clin Epidemiol 2013; 5:47-55. [PMID: 24227923 PMCID: PMC3820473 DOI: 10.2147/clep.s47153] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective We investigated temporal changes in overall survival among prostate cancer (PC) patients and the impact of comorbidity on all-cause mortality. Methods We conducted a population-based cohort study in the Central Denmark Region (1.2 million inhabitants). Using medical registries, we identified 7,654 PC patients with first-time PC diagnosis within the period 2000–2011 and their corresponding comorbidities within 10 years prior to the PC diagnosis. We estimated 1- and 5-year survival in four consecutive calendar periods using a hybrid analysis and plotted Kaplan–Meier survival curves. We used Cox proportional hazards regression to compute 1- and 5-year age-adjusted mortality rate ratios (MRRs) for different comorbidity levels. All estimates are reported with their corresponding 95% confidence intervals (CI). Results The annual number of PC cases doubled over the 12-year study period. Men aged <70 years accounted for the largest proportional increase (from 33% to 47%). The proportion of patients within each comorbidity category remained constant over time. One-year survival increased from 82% (CI: 80%–84%) in 2000–2002 to 92% (CI: 90%–93%) in 2009–2011, while 5-year survival increased from 43% (CI: 40%–46%) to 65% (CI: 62%–67%) during the same time intervals. Improvements in 5-year survival were most prominent among patients aged <80 years and among those with no comorbidity (from 51% to 73%) and medium comorbidity (from 32% to 54%). Improvements in survival were much smaller for those with high comorbidity (from 33% to 39%). The 1-year age-adjusted MRR for patients with high comorbidity (relative to patients with no comorbidity) increased over time from 1.84 (CI: 1.19–2.84) to 3.67 (CI: 2.49–5.41), while the 5-year age-adjusted MRR increased from 1.73 (CI: 1.34–2.23) to 2.38 (CI: 1.93–2.94). Conclusion Overall survival of PC improved substantially during 2000–2011, although primarily among men with low comorbidity. All-cause mortality was highest among PC patients with high comorbidity, and their relative 1- and 5-year mortality increased over time compared to those without comorbidity.
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Affiliation(s)
- Mary Nguyen-Nielsen
- Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
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21
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Jiang Y, Gauthier A, Postma MJ, Ribassin-Majed L, Largeron N, Bresse X. A critical review of cost-effectiveness analyses of vaccinating males against human papillomavirus. Hum Vaccin Immunother 2013; 9:2285-95. [PMID: 23880955 PMCID: PMC3981835 DOI: 10.4161/hv.25754] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 07/01/2013] [Accepted: 07/15/2013] [Indexed: 12/15/2022] Open
Abstract
A critical review of cost-effectiveness analyses of HPV vaccination in males was conducted and nine studies were identified in different countries. Due to the heterogeneity among these studies in terms of modeling approach, vaccination strategies, health outcomes considered, assumptions and parameters, limited conclusions can be drawn with regard to the absolute cost-effectiveness. Nevertheless, key drivers were identified. More favorable cost-effectiveness appeared when all HPV-related diseases outcomes were considered, a suboptimal vaccine coverage among girls and/or lower vaccine prices were assumed. There was a general lack of transparency to fully describe the details of the methodological approach of modeling and calibration. Further research should be conducted to generate robust evidence-based data sets (HPV-related diseases epidemiology, costs and quality of life). The best modeling practice for HPV vaccination and how to better capture the true economic value of vaccination beyond cost-effectiveness in a broader policy context need to be investigated.
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Affiliation(s)
| | | | | | - Laureen Ribassin-Majed
- Laboratoire Mathématiques Appliquées à Paris 5; Centre National de la Recherche Scientifique Unité Mixte de Recherche n°8145, Université Paris Descartes; Sorbonne Paris Cité; Paris, France
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22
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Differences in survival from prostate cancer in Denmark, Iceland and Sweden. Eur J Cancer 2013; 49:1984-92. [DOI: 10.1016/j.ejca.2013.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Revised: 01/06/2013] [Accepted: 01/15/2013] [Indexed: 11/19/2022]
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23
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Verhoeven R, Janssen-Heijnen M, Saum K, Zanetti R, Caldarella A, Holleczek B, Brewster D, Hakulinen T, Horenblas S, Brenner H, Gondos A. Population-based survival of penile cancer patients in Europe and the United States of America: No improvement since 1990. Eur J Cancer 2013; 49:1414-21. [DOI: 10.1016/j.ejca.2012.10.029] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 10/30/2012] [Accepted: 10/30/2012] [Indexed: 11/27/2022]
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Røder MA, Brasso K, Christensen IJ, Johansen J, Langkilde NC, Hvarness H, Carlsson S, Jakobsen H, Borre M, Iversen P. Survival after radical prostatectomy for clinically localised prostate cancer: a population-based study. BJU Int 2013; 113:541-7. [PMID: 23495721 DOI: 10.1111/bju.12065] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Martin Andreas Røder
- Copenhagen Prostate Cancer Center and Department of Urology; Rigshospitalet Copenhagen University Hospital; Faculty of Health and Medical Sciences; Copenhagen
| | - Klaus Brasso
- Copenhagen Prostate Cancer Center and Department of Urology; Rigshospitalet Copenhagen University Hospital; Faculty of Health and Medical Sciences; Copenhagen
| | - Ib Jarle Christensen
- The Finsen Laboratory; Copenhagen Biotech Research and Innovation Centre (BRIC); Rigshospitalet Copenhagen University Hospital; Faculty of Health and Medical Sciences; Copenhagen
| | - Jørgen Johansen
- Department of Urology; Regional Hospital West Jutland; Holstebro
| | | | - Helle Hvarness
- Copenhagen Prostate Cancer Center and Department of Urology; Rigshospitalet Copenhagen University Hospital; Faculty of Health and Medical Sciences; Copenhagen
| | - Steen Carlsson
- Department of Urology; Odense University Hospital; Faculty of Health Sciences; Odense
| | - Henrik Jakobsen
- Department of Urology; Herlev Hospital; Copenhagen University Hospital; Faculty of Health and Medical Sciences; Herlev
| | - Michael Borre
- Department of Urology, Skejby; Aarhus University Hospital; Department of Clinical Medicine; Aarhus Denmark
| | - Peter Iversen
- Copenhagen Prostate Cancer Center and Department of Urology; Rigshospitalet Copenhagen University Hospital; Faculty of Health and Medical Sciences; Copenhagen
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Ulff-Møller CJ, Simonsen J, Frisch M. Marriage, cohabitation and incidence trends of invasive penile squamous cell carcinoma in Denmark 1978-2010. Int J Cancer 2013; 133:1173-9. [PMID: 23404289 DOI: 10.1002/ijc.28107] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 01/28/2013] [Indexed: 11/09/2022]
Abstract
Few population-based studies have investigated the relation between living arrangements and risk of invasive penile squamous cell carcinoma (iP-SCC). Using long-term national cancer registry data in Denmark we examined incidence trends of iP-SCC. Furthermore, we examined the relation between marital status, cohabitation status and risk of iP-SCC using hazard ratios (HRs) with 95% confidence intervals (CIs) obtained in Cox proportional hazards regression analyses as our measure of relative risk. Overall, 1,292 cases of iP-SCC were identified during 65.6 million person-years of observation between 1978 and 2010. During this period, the WHO world age-standardized incidence remained relatively stable (p-trend = 0.41) with an average incidence of 1.05 cases per 100,000 person-years. When compared to married men, those who were unmarried (HR 1.37; 95% CI: 1.13-1.66), divorced (HR 1.49; 95% CI: 1.24-1.79) or widowed (HR 1.36; 95% CI: 1.13-1.63) were at increased risk of iP-SCC. Regarding cohabitation status, single-living men were at increased risk of iP-SCC compared to men in opposite-sex cohabitation (HR 1.43; 95% CI: 1.26-1.62). Risk increased with increasing numbers of prior opposite-sex (p-trend = 0.02) and same-sex (p-trend < 0.001) cohabitations. In conclusion, single-living Danish men and men who are not currently married are at increased risk of iP-SCC, and the risk increases with the number of prior cohabitations, perhaps reflecting less stable sexual relations in these subgroups.
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Jooste V, Grosclaude P, Remontet L, Launoy G, Baldi I, Molinié F, Arveux P, Bossard N, Bouvier AM, Colonna M. Unbiased estimates of long-term net survival of solid cancers in France. Int J Cancer 2013; 132:2370-7. [PMID: 23001495 DOI: 10.1002/ijc.27857] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 09/03/2012] [Indexed: 01/03/2023]
Abstract
In cancer studies, net survival (observed if cancer was the only cause of death) is a useful indicator but survival estimation at 5 years is insufficient for planning healthcare needs. We estimated the net survivals at 5 and 10 years in a cohort of 387,961 patients who had solid tumors between 1989 and 2004 and were followed-up until January 1, 2008. The cases were actively followed-up. Net survival was estimated with the unbiased Pohar-Perme method. The standardized net survival used the international cancer survival standard weights. In men, the standardized net survivals ranged from 92% at 5 years and 89% at 10 years (testis) to 6% at 5 years and 5% at 10 years (pancreas). In women, it ranged from 91% at 5 years and 88% at 10 years (thyroid) to 10% at 5 years and 7% at 10 years (pancreas). The most frequent cancers had the highest net survivals: 84% at 5 years and 71% at 10 years for prostate and 84% at 5 years and 74% at 10 years for breast cancer. Advanced age was associated with poorer prognosis. In most cancers, the net survivals at 5 and 10 years increased over periods of diagnosis. Net cancer survival is unaffected by mortalities due to other causes. It is the only indicator suitable for comparisons between countries or periods of diagnosis within a given country. The 10-year net survival confirmed the persistent unfavorable role of age in prognosis and the general improvement of cancer management over the last decade.
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Affiliation(s)
- Valérie Jooste
- FRANCIM (French Network of Cancer Registries), Toulouse, France
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Prostate cancer incidence and survival in immigrants to Sweden. World J Urol 2013; 31:1483-8. [PMID: 23306784 DOI: 10.1007/s00345-012-1021-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 12/27/2012] [Indexed: 10/27/2022] Open
Abstract
PURPOSE The large international variation in the incidence of prostate cancer (PC) is well known but the underlying reasons are not understood. We want to compare PC incidence and survival among immigrants to Sweden in order to explain the international differences. METHODS Cancer data were obtained from the Swedish Cancer Registry. Standardized incidence ratios (SIRs) were calculated for PC in first-degree immigrants by country of birth. The immigrants were classified into four groups by SIR and area of origin. Survival in PC was assessed by hazard ratio (HR) in the four groups. In some analyses, clinical stage of PC was assessed by the tumor, node, and metastasis classification. RESULTS The SIR was 0.47 (95% confidence interval 0.43-0.51) for immigrants with the lowest risk, constituting men from Turkey, Middle East, Asia, and Chile. The HR was 0.60 (0.45-0.81) for these men and it was 0.49 if they had stayed 20+ years in Sweden. The SIR in screening detected PC, T1c, was 0.55. Among these men, screening detected PC constituted 34.5% of all PC, compared to 29.0% among Swedes (p = 0.10). CONCLUSIONS The results showed that the non-European immigrants, of mainly Middle East, Asian, and Chilean origin, with the lowest risk of PC, also had the most favorable survival in PC. As the available clinical features of PC at diagnosis or the distribution of known risk factors could not explain the differences, a likely biological mechanism through a favorable androgenic hormonal host environment is suggested as an explanation of the observed effects.
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Znaor A, Bray F. Thirty year trends in testicular cancer mortality in Europe: gaps persist between the East and West. Acta Oncol 2012; 51:956-8. [PMID: 22548368 DOI: 10.3109/0284186x.2012.681701] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Ondrus D, Ondrusova M, Dusek L. Recent patterns in testicular cancer incidence, mortality and survival in the Slovak Republic with reference to international comparisons. Cancer Invest 2012; 30:545-51. [PMID: 22909019 DOI: 10.3109/07357907.2012.700984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Incidence of testicular cancer in the Slovak Republic (SR) sharply increased in 1968-2006 (annual change 0.195/100,000, 95% CI = -0.178-0.212, p < .0001). Mortality was stabilized in 1968-2006 (-0.005/100,000/year, 95% CI = -0.011-0.001, p = .148), however, from 1990, it had a mildly significant decreasing trend. The 5-year relative survival for patients from the cohort 1993-1997 reached 91.7% (95% CI = 87.5-94.7), for the cohort 1998-2002, it was 93.2% (95% CI = 89.5-95.8). The average age of patients with seminomas was 30-41 years (25-75% quantile), for nonseminomas 23-34 years (25-75% quantile).
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Affiliation(s)
- Dalibor Ondrus
- Department of Oncology, Comenius University Faculty of Medicine, Bratislava, Slovak Republic.
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Nguyen-Nielsen M, Frøslev T, Friis S, Borre M, Harving N, Søgaard M. Completeness of prostate cancer staging in the Danish Cancer Registry, 2004-2009. Clin Epidemiol 2012; 4 Suppl 2:17-23. [PMID: 22936853 PMCID: PMC3429153 DOI: 10.2147/clep.s32004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the completeness of TNM (Tumor-Node-Metastasis) staging for prostate cancer (PC) in the Danish Cancer Registry (DCR). METHODS We identified 20,184 men registered with first-time PC in the DCR between 2004 and 2009. These patients were linked to the Danish National Patient Register to obtain data on comorbidity according to the Charlson Comorbidity Index (CCI). We calculated the completeness and corresponding 95% confidence intervals (CI) of TNM staging overall and by the individual components. We also defined a clinically-based algorithm classifying PC into four stage categories: localized, regional, distant, and unknown. RESULTS The overall completeness of TNM staging was 34.2% (95% CI: 0.34-0.35). TNM completeness improved gradually over time reaching 41.2% in 2009. TNM completeness decreased substantially with age from 75.0% among patients 0-39 years to 11.3% among patients 80 years or older. Similarly, completeness decreased with increasing comorbidity level from 37.6% among patients with low CCI to 20.3% among those with high CCI. When classifying T1 cancer as a complete registration regardless of missing N or M stage, the overall TNM completeness increased to 48.7% (95% CI: 0.48-0.49). According to the clinically-based staging algorithm, 70.5% of PC cases could be categorized into a definite clinical stage. CONCLUSION One-third of PC patients had a complete registration of all TNM components in the DCR. Although TNM completeness improved over time, older age and high comorbidity were consistently associated with missing TNM staging. Research and monitoring based on cancer registries such as the DCR should account for missing TNM staging. Failing to do so could otherwise lead to biased results of stage-specific analyses.
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Soerjomataram I, Lortet-Tieulent J, Ferlay J, Forman D, Mathers C, Parkin DM, Bray F. Estimating and validating disability-adjusted life years at the global level: a methodological framework for cancer. BMC Med Res Methodol 2012; 12:125. [PMID: 22901001 PMCID: PMC3490831 DOI: 10.1186/1471-2288-12-125] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 05/18/2012] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Disability-adjusted life years (DALYs) link data on disease occurrence to health outcomes, and they are a useful aid in establishing country-specific agendas regarding cancer control. The variables required to compute DALYs are however multiple and not readily available in many countries. We propose a methodology that derives global DALYs and validate variables and DALYs based on data from various cancer registries. METHODS We estimated DALYs for four countries (Norway, Bulgaria, India and Uganda) within each category of the human development index (HDI). The following sources (indicators) were used: Globocan2008 (incidence and mortality), various cancer registries (proportion cured, proportion treated and duration of disease), treatment guidelines (duration of treatment), specific burden of disease studies (sequelae and disability weights), alongside expert opinion. We obtained country-specific population estimates and identified resource levels using the HDI, DALYs are computed as the sum of years of life lost and years lived with disabilities. RESULTS Using mortality:incidence ratios to estimate country-specific survival, and by applying the human development index we derived country-specific estimates of the proportion cured and the proportion treated. The fit between the estimates and observed data from the cancer registries was relatively good. The final DALY estimates were similar to those computed using observed values in Norway, and in WHO's earlier global burden of disease study. Marked cross-country differences in the patterns of DALYs by cancer sites were observed. In Norway and Bulgaria, breast, colorectal, prostate and lung cancer were the main contributors to DALYs, representing 54% and 45%, respectively, of the totals. These cancers contributed only 27% and 18%, respectively, of total DALYs in India and Uganda. CONCLUSIONS Our approach resulted in a series of variables that can be used to estimate country-specific DALYs, enabling global estimates of DALYs and international comparisons that support priorities in cancer control.
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Affiliation(s)
- Isabelle Soerjomataram
- Department of Public Health, Erasmus MC, Rotterdam, the Netherlands
- Department of Global Health and Population, Harvard School of Public Health, Boston, USA
- Section of Cancer Information, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, 69372, France
| | - Joannie Lortet-Tieulent
- Section of Cancer Information, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, 69372, France
| | - Jacques Ferlay
- Section of Cancer Information, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, 69372, France
| | - David Forman
- Section of Cancer Information, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, 69372, France
| | | | - D Maxwell Parkin
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK
| | - Freddie Bray
- Section of Cancer Information, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, 69372, France
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Torfadottir JE, Valdimarsdottir UA, Mucci L, Stampfer M, Kasperzyk JL, Fall K, Tryggvadottir L, Aspelund T, Olafsson O, Harris TB, Jonsson E, Tulinius H, Adami HO, Gudnason V, Steingrimsdottir L. Rye bread consumption in early life and reduced risk of advanced prostate cancer. Cancer Causes Control 2012; 23:941-50. [PMID: 22527172 DOI: 10.1007/s10552-012-9965-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 04/07/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine whether consumption of whole-grain rye bread, oatmeal, and whole-wheat bread, during different periods of life, is associated with risk of prostate cancer (PCa). METHODS From 2002 to 2006, 2,268 men, aged 67-96 years, reported their dietary habits in the AGES-Reykjavik cohort study. Dietary habits were assessed for early life, midlife, and current life using a validated food frequency questionnaire. Through linkage to cancer and mortality registers, we retrieved information on PCa diagnosis and mortality through 2009. We used regression models to estimate odds ratios (ORs) and hazard ratios (HRs) for PCa according to whole-grain consumption, adjusted for possible confounding factors including fish, fish liver oil, meat, and milk intake. RESULTS Of the 2,268 men, 347 had or were diagnosed with PCa during follow-up, 63 with advanced disease (stage 3+ or died of PCa). Daily rye bread consumption in adolescence (vs. less than daily) was associated with a decreased risk of PCa diagnosis (OR = 0.76, 95 % confidence interval (CI): 0.59-0.98) and of advanced PCa (OR = 0.47, 95 % CI: 0.27-0.84). High intake of oatmeal in adolescence (≥5 vs. ≤4 times/week) was not significantly associated with risk of PCa diagnosis (OR = 0.99, 95 % CI: 0.77-1.27) nor advanced PCa (OR = 0.67, 95 % CI: 0.37-1.20). Midlife and late life consumption of rye bread, oatmeal, or whole-wheat bread was not associated with PCa risk. CONCLUSION Our results suggest that rye bread consumption in adolescence may be associated with reduced risk of PCa, particularly advanced disease.
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Affiliation(s)
- Johanna E Torfadottir
- Centre of Public Health Sciences, University of Iceland, Stapi v/Hringbraut 101, Reykjavik, Iceland.
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Paternal Benzo[a]pyrene Exposure Modulates MicroRNA Expression Patterns in the Developing Mouse Embryo. Int J Cell Biol 2012; 2012:407431. [PMID: 22548065 PMCID: PMC3324892 DOI: 10.1155/2012/407431] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 01/19/2012] [Indexed: 12/02/2022] Open
Abstract
Little attention has been given to how microRNA expression is affected by environmental contaminants exposure. We investigate the effects of paternal exposure to benzo[a]pyrene (B[a]P) on miRNA expression in the developing mouse embryo. Male mice were exposed to B[a]P (150 mg/kg i.p.), and their sperm was used four days later in in-vitro fertilization experiments. Twenty embryos each from 2-, 8-cell and the blastocyst stage were used for genome-wide miRNA expression profiling. Paternal exposure to B[a]P affected the expression of several miRNAs, and the target genes for some of the dysregulated miRNAs were enriched in many different pathways that are likely to be relevant for the developing mouse embryo. By linking the miRNA target genes to publicly available databases, we identified some miRNA target genes that may serve as global markers of B[a]P-mediated genotoxic stress. The dysregulated miRNAs may provide valuable knowledge about potential transgenerational effects of sublethal exposure to chemicals.
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Questionable evidence of increasing incidence of invasive penile cancer in Denmark. Cancer Causes Control 2012; 23:659-60; author reply 661-2. [DOI: 10.1007/s10552-012-9933-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 02/20/2012] [Indexed: 11/26/2022]
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A comparison of prostate cancer survival in England, Norway and Sweden: A population-based study. Cancer Epidemiol 2012; 36:e7-12. [DOI: 10.1016/j.canep.2011.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 08/04/2011] [Indexed: 11/21/2022]
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Familial risk and familial survival in prostate cancer. World J Urol 2011; 30:143-8. [DOI: 10.1007/s00345-011-0801-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 11/12/2011] [Indexed: 02/07/2023] Open
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Increased incidence of penile cancer and high-grade penile intraepithelial neoplasia in Denmark 1978–2008: a nationwide population-based study. Cancer Causes Control 2011; 23:273-80. [DOI: 10.1007/s10552-011-9876-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 11/10/2011] [Indexed: 12/23/2022]
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Vlayen J, Vrijens F, Devriese S, Beirens K, Van Eycken E, Stordeur S. Quality indicators for testicular cancer: a population-based study. Eur J Cancer 2011; 48:1133-40. [PMID: 22105018 DOI: 10.1016/j.ejca.2011.10.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 10/17/2011] [Accepted: 10/19/2011] [Indexed: 10/15/2022]
Abstract
PURPOSE This study aimed at developing and measuring an indicator set to monitor the quality of testicular cancer care, to make comparisons over time and to support quality improvement for all practitioners and centres involved in the care of testicular cancer patients. METHODS Quality indicators were identified from a systematic literature search and from the 2010 Belgian evidence-based clinical practice guidelines. The selection process involved an expert panel evaluating reliability, relevance, interpretability and actionability of each indicator. The quality indicators were pilot tested using the Belgian Cancer Registry (BCR) data linked with claims data for 1307 men with testicular cancer diagnosed between 2001 and 2006. The variability between centres was displayed using funnel plots. RESULTS Of the 12 finally selected indicators, 5 were fully and 1 was partly measurable, while 2 indicators were measurable using proxy information. Five-year relative survival was 97%, 95% and 76% for pStage I-III, respectively. Overall 5-year survival slightly improved from 91% in 2001 to 94% in 2004. Between 2004 and 2006, 14 of 97 centres performed ≥10 orchidectomies. Large variability was found between centres. The nine centres with a 5-year observed survival below the lower limit treated less than 20 patients between 2001 and 2006. CONCLUSIONS The present study demonstrates the feasibility to develop a multidisciplinary set of quality indicators for testicular cancer. Using national cancer registry data linked to claims data, eight indicators were measurable, showing a mixed picture of the quality of care for testicular cancer patients in Belgium.
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Affiliation(s)
- Joan Vlayen
- Belgian Health Care Knowledge Centre, Boulevard du Botanique 55, Brussels, Belgium
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Global Trends in Testicular Cancer Incidence and Mortality. Eur Urol 2011; 60:374-9. [DOI: 10.1016/j.eururo.2011.05.004] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 05/02/2011] [Indexed: 02/08/2023]
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Borre M, Erichsen R, Lund L, Larsen EH, Nørgaard M, Jacobsen JB. Survival of prostate cancer patients in central and northern Denmark, 1998-2009. Clin Epidemiol 2011; 3 Suppl 1:41-6. [PMID: 21814469 PMCID: PMC3144777 DOI: 10.2147/clep.s20625] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Prostate cancer is the most common noncutaneous cancer among Danish men. During the last decade, use of prostate specific antigen (PSA) testing has increased, and in clinically localized prostate cancer, curative intended treatment has gained a footing. Our aim was to examine possible changes in the short- and long-term survival of patients with prostate cancer during 1998-2009. STUDY DESIGN AND SETTING From two Danish regions (population, 1.8 million) we included all patients (N = 10,547) with an incident diagnosis of prostate cancer retrieved from the Danish National Registry of Patients. We determined survival after 1, 3, and 5 years, stratified by age, and estimated mortality rate ratios (MRRs) using Cox proportional hazard regression to assess changes over time, controlling for age. RESULTS During the study period, the annual number of incident prostate cancer patients more than doubled, and the median age at diagnosis decreased from 74 to 70 years. The survival improved over the study period, particularly in the last half of the period (2004-2009). Thus, 1-year survival increased from 80% (1998-2000) to 90% (2007-2009), corresponding to an age-adjusted MRR of 0.54 (95% confidence interval CI: 0.46-0.63). The expected increase in 3- and 5-year survival was even more pronounced: 47%-73% and 34%-60%, respectively. This corresponded to a 3-year age-adjusted MRR of 0.46 (95% CI: 0.42-0.51) and a 5-year MRR of 0.50 (95% CI: 0.46-0.54). The 1-, 3-, and 5-year overall survival increased in all age groups (<70 years, 70-79 years, ≥80 years). CONCLUSION Survival after prostate cancer has improved in Denmark within the last decade. Although diagnosis and treatment improvements could explain this, length and lead time bias are likely to have influenced our results.
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Affiliation(s)
- Michael Borre
- Department of Clinical Epidemiology, Aarhus University Hospital, Denmark
- Department of Urology, Aarhus University Hospital, Skejby, Denmark
| | - Rune Erichsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Denmark
| | - Lars Lund
- Department of Urology, Region Hospital Viborg, Denmark
| | | | - Mette Nørgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Denmark
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Storm HH, Engholm G, Hakulinen T, Tryggvadóttir L, Klint A, Gislum M, Kejs AMT, Bray F. Survival of patients diagnosed with cancer in the Nordic countries up to 1999-2003 followed to the end of 2006. A critical overview of the results. Acta Oncol 2010; 49:532-44. [PMID: 20491522 DOI: 10.3109/02841861003801148] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
UNLABELLED Differences in Nordic cancer patient survival observed today originate from the 1970s, but were first identified in a mortality prediction from 1995. This paper provides timely comparisons of survival using NORDCAN, a database with comparable information from the Nordic cancer registries. Elucidation of the differences is important when monitoring cancer care generally and evaluating the impact of cancer plans. MATERIAL AND METHODS The NORDCAN database 1964-2003 with follow-up for death through 2006, was used to analyse incidence, mortality, and survival for all NORDCAN cancer sites. We analysed 5-year relative survival and excess mortality rates in the first three months and 2-5 years after diagnosis. RESULTS The time trends in survival 1989-2003 were largely similar between the Nordic countries with increases in 14 sites among men and 16 among women. In all countries the excess mortality rates were highest in the first three months after diagnosis, but decreased to similar levels across all countries 2-5 years after diagnosis. Comparing countries excess mortality was highest in Denmark irrespective of follow-up period. Lower survival was observed for Danish cancer patients in 23 of the 33 cancer sites in men and 26 of 35 sites in women. Low and similar levels of survival were observed for cancers of the oesophagus, lung, liver and pancreas, while an 8-10 percentage point difference in survival was found between countries for colorectal cancer. CONCLUSION The notable differences in Nordic cancer patient survival can be linked to national variations in risk factors, co-morbidity, and the implementation of screening. Improved treatment and primary prevention, in particular the targeting of tobacco and alcohol use, is required to improve cancer control. The recently-initiated cancer plans in Denmark and Norway are yet to show an observable effect on the corresponding cancer survival.
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Affiliation(s)
- Hans H Storm
- Department of Cancer Prevention and Documentation, Danish Cancer Society, Strandboulevarden 49, Copenhagen, Denmark.
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Engholm G, Gislum M, Bray F, Hakulinen T. Trends in the survival of patients diagnosed with cancer in the Nordic countries 1964-2003 followed up to the end of 2006. Material and methods. Acta Oncol 2010; 49:545-60. [PMID: 20491523 DOI: 10.3109/02841861003739322] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED Comparable data on cancer incidence and mortality in Denmark, Finland, Iceland, Norway, and Sweden are available for analysis through a collaboration of the national Cancer Registries via the NORDCAN website (http://ancr.nu). In the continued spirit of Nordic collaborative research, a number of studies examining trends in cancer survival are published in this journal. MATERIAL AND METHODS The data were divided into eight 5-year periods by sex in five Nordic countries. Age-standardised 5-year relative survival ratios and excess mortality rates in the short-term (first month and 1-3 months following diagnosis), and the long-term (2-5 years after diagnosis) were calculated, as were age-specific 5-year relative survival using cohort-survival methods. A hybrid method combining the cohort and period methods was used for the period 1999-2003 as not all patients were followed for five years. Age-standardisation used the International Cancer Survival Standard, and calculation of expected deaths used country-specific population mortality rates. RESULTS The data series constitutes 3 360 397 tumours among 3 160 802 patients followed up for death through 2006 for 39 different cancer sites diagnosed in the years 1964-2003. The paper describes the data, exclusions and imputations, design and analysis, age structure and standardisation procedures, follow-up, and case-mix adjustment methods. CONCLUSION The strengths of this study include the overall comparability and quality of the data, the national coverage, and the length of the time series. Collecting and analysing data from the five Nordic countries for 39 different cancer sites over 40 years in a systematised and comparable way is a major undertaking. A thorough description of the analyses, definitions and exclusions in the survival study, supplemented with corresponding information on cancer incidence and mortality is needed for appropriate interpretation and comparison between countries, and between and within cancer sites. This information must be made available to provide appropriate interpretation of the site-specific results.
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Affiliation(s)
- Gerda Engholm
- Department of Cancer Prevention and Documentation, Danish Cancer Society, Strandboulevarden 49, Copenhagen Ø, Denmark.
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