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Peacock HM, van Walle L, Silversmit G, Neven P, Han SN, Van Damme N. Breast cancer incidence, stage distribution, and treatment shifts during the 2020 COVID-19 pandemic: a nationwide population-level study. Arch Public Health 2024; 82:66. [PMID: 38715074 PMCID: PMC11075279 DOI: 10.1186/s13690-024-01296-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The first COVID-19 wave in 2020 necessitated temporary suspension of non-essential medical services including organized cancer screening programs in Belgium. This study assessed the impact of the pandemic on breast cancer (BC) incidence, stage at diagnosis, and management in Belgium in 2020. METHODS All Belgian residents diagnosed with in situ or invasive BC in 2015-2020 in the nationwide, population-based cancer registry database were included. Incidence trends for 2015-2019 were extrapolated to predict incidence and stage distribution for 2020 and compared with the observed values. National healthcare reimbursement data were used to examine treatment strategies. Exact tumor diameter and nodal involvement, extracted from pathology reports, were analyzed for 2019 and 2020. RESULTS 74,975 tumors were selected for analysis of incidence and clinical stage. Invasive BC incidence declined by -5.0% in 2020, with a drop during the first COVID-19 wave (Mar-Jun; -23%) followed by a rebound (Jul-Dec; +7%). Predicted and observed incidence (in situ + invasive) was not different in patients < 50 years. In the 50-69 and 70 + age groups, significant declines of -4.1% and - 8.4% respectively were found. Excess declines were seen in clinical stage 0 and I in Mar-Jun, without excess increases in clinical stage II-IV tumors in Jul-Dec. There was no increase in average tumor diameter or nodal involvement in 2020. Patients diagnosed in Mar-Jun received significantly more neoadjuvant therapy, particularly neoadjuvant hormonal therapy for patients with clinical stage I-II BC. CONCLUSIONS BC incidence decline in 2020 in Belgium was largely restricted to very early-stage BC and patients aged 50 and over. Delayed diagnosis did not result in an overall progression to higher stage at diagnosis in 2020. Observed treatment adaptations in Belgium were successful in prioritizing patients for surgery while preventing tumor progression in those with surgical delay. Continuation of monitoring BC incidence and stage in the future is crucial.
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Affiliation(s)
- Hanna M Peacock
- Research Department, Belgian Cancer Registry, Koningsstraat 215 bus 7, Brussels, 1210, Belgium
| | - Lien van Walle
- Research Department, Belgian Cancer Registry, Koningsstraat 215 bus 7, Brussels, 1210, Belgium
| | - Geert Silversmit
- Research Department, Belgian Cancer Registry, Koningsstraat 215 bus 7, Brussels, 1210, Belgium
| | - Patrick Neven
- Department of Gynecological Oncology and Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - Sileny N Han
- Department of Gynecological Oncology and Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - Nancy Van Damme
- Research Department, Belgian Cancer Registry, Koningsstraat 215 bus 7, Brussels, 1210, Belgium.
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Hochheiser H, Finan S, Yuan Z, Durbin EB, Jeong JC, Hands I, Rust D, Kavuluru R, Wu XC, Warner JL, Savova G. DeepPhe-CR: Natural Language Processing Software Services for Cancer Registrar Case Abstraction. medRxiv 2023:2023.05.05.23289524. [PMID: 37205575 PMCID: PMC10187451 DOI: 10.1101/2023.05.05.23289524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Objective The manual extraction of case details from patient records for cancer surveillance efforts is a resource-intensive task. Natural Language Processing (NLP) techniques have been proposed for automating the identification of key details in clinical notes. Our goal was to develop NLP application programming interfaces (APIs) for integration into cancer registry data abstraction tools in a computer-assisted abstraction setting. Methods We used cancer registry manual abstraction processes to guide the design of DeepPhe-CR, a web-based NLP service API. The coding of key variables was done through NLP methods validated using established workflows. A container-based implementation including the NLP wasdeveloped. Existing registry data abstraction software was modified to include results from DeepPhe-CR. An initial usability study with data registrars provided early validation of the feasibility of the DeepPhe-CR tools. Results API calls support submission of single documents and summarization of cases across multiple documents. The container-based implementation uses a REST router to handle requests and support a graph database for storing results. NLP modules extract topography, histology, behavior, laterality, and grade at 0.79-1.00 F1 across common and rare cancer types (breast, prostate, lung, colorectal, ovary and pediatric brain) on data from two cancer registries. Usability study participants were able to use the tool effectively and expressed interest in adopting the tool. Discussion Our DeepPhe-CR system provides a flexible architecture for building cancer-specific NLP tools directly into registrar workflows in a computer-assisted abstraction setting. Improving user interactions in client tools, may be needed to realize the potential of these approaches. DeepPhe-CR: https://deepphe.github.io/.
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Affiliation(s)
- Harry Hochheiser
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, USA
- Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sean Finan
- Boston Childrens' Hospital, Boston, MA, USA and Harvard Medical School, Boston, MA, USA
| | - Zhou Yuan
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eric B Durbin
- Kentucky Cancer Registry, Markey Cancer Center, Lexington, KY, USA
- Division of Biomedical Informatics, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Jong Cheol Jeong
- Division of Biomedical Informatics, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Isaac Hands
- Kentucky Cancer Registry, Markey Cancer Center, Lexington, KY, USA
- Division of Biomedical Informatics, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - David Rust
- Kentucky Cancer Registry, Markey Cancer Center, Lexington, KY, USA
| | - Ramakanth Kavuluru
- Division of Biomedical Informatics, College of Medicine, University of Kentucky, Lexington, KY, USA
| | | | - Jeremy L Warner
- Lifespan Health System, Providence, RI, USA
- Legorreta Cancer Center at Brown University, Providence, RI, USA
| | - Guergana Savova
- Boston Childrens' Hospital, Boston, MA, USA and Harvard Medical School, Boston, MA, USA
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3
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Rugge M, Zorzi M, Guzzinati S, Stocco C, Avossa F, Del Zotto S, Clagnan E, Bricca L, Dal Maso L, Serraino D. Outcomes of SARS-CoV-2 infection in cancer versus non-cancer-patients: a population-based study in northeastern Italy. Tumori 2023; 109:38-46. [PMID: 35130777 PMCID: PMC9895302 DOI: 10.1177/03008916211073771] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION This study assesses the risk of infection and clinical outcomes in a large consecutive population of cancer and non-cancer patients tested for SARS-CoV-2 status. METHODS Study patients underwent SARS-CoV-2 molecular-testing between 22 February 2020 and 31 July 2020, and were found infected (CoV2+ve) or uninfected. History of malignancy was obtained from regional population-based cancer registries. Cancer-patients were distinguished by time between cancer diagnosis and SARS-CoV-2 testing (<12/⩾12 months). Comorbidities, hospitalization, and death at 15 September 2020 were retrieved from regional population-based databases. The impact of cancer history on SARS-CoV-2 infection and clinical outcomes was calculated by fitting a multivariable logistic regression model, adjusting for sex, age, and comorbidities. RESULTS Among 552,362 individuals tested for SARS-CoV-2, 55,206 (10.0%) were cancer-patients and 22,564 (4.1%) tested CoV2+ve. Irrespective of time since cancer diagnosis, SARS-CoV-2 infection was significantly lower among cancer patients (1,787; 3.2%) than non-cancer individuals (20,777; 4.2% - Odds Ratio (OR)=0.60; 0.57-0.63). CoV2+ve cancer-patients were older than non-cancer individuals (median age: 77 versus 57 years; p<0.0001), were more frequently men and with comorbidities. Hospitalizations (39.9% versus 22.5%; OR=1.61; 1.44-1.80) and deaths (24.3% versus 9.7%; OR=1.51; 1.32-1.72) were more frequent in cancer-patients. CoV2+ve cancer-patients were at higher risk of death (lung OR=2.90; 1.58-5.24, blood OR=2.73; 1.88-3.93, breast OR=1.77; 1.32-2.35). CONCLUSIONS The risks of hospitalization and death are significantly higher in CoV2+ve individuals with past or present cancer (particularly malignancies of the lung, hematologic or breast) than in those with no history of cancer.
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Affiliation(s)
- Massimo Rugge
- Department of Medicine - DIMED,
Surgical Pathology and Cytopathology Unit, Università degli Studi di Padova, Padova,
Italy,Veneto Tumour Registry, Azienda Zero,
Padova, Italy
| | - Manuel Zorzi
- Veneto Tumour Registry, Azienda Zero,
Padova, Italy
| | | | | | - Francesco Avossa
- Regional Epidemiological Service Unit,
Azienda Zero, Padova, Italy
| | | | - Elena Clagnan
- Friuli Venezia Giulia Regional Health
Coordination Agency, Udine, Italy
| | - Ludovica Bricca
- Department of Medicine - DIMED,
Surgical Pathology and Cytopathology Unit, Università degli Studi di Padova, Padova,
Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di
Riferimento Oncologico, IRCCS, Aviano, Italy,Luigino Dal Maso, Cancer Epidemiology,
Centro di Riferimento Oncologico (CRO) Aviano, via Gallini, 2, Aviano (PN),
33081, Italy.
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di
Riferimento Oncologico, IRCCS, Aviano, Italy
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Kang CJ, Wen YW, Lee SR, Ng SH, Lee LA, Lee LY, Hsueh C, Lin CY, Fan KH, Wang HM, Hsieh CH, Yeh CH, Tsai CY, Lin CH, Tsao CK, Fang TJ, Huang SF, Fang KH, Wang YC, Lin WN, Hsin LJ, Yen TC, Cheng NM, Liao CT. Clinical outcomes of patients with pT4a and pT4b oral cavity squamous cell carcinoma who had undergone surgery: Results from a Taiwanese registry-based, nationwide cohort study. Oral Oncol 2022; 126:105750. [PMID: 35123256 DOI: 10.1016/j.oraloncology.2022.105750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/11/2022] [Accepted: 01/25/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVES While the NCCN guidelines maintain that T4b oral cavity squamous cell carcinoma (OCSCC) should undergo either non-surgical treatments or clinical trials, promising outcomes of T4b OCSCC having surgical excision have been reported. We analyzed and compared the clinical outcomes of Taiwanese patients with pT4a and pT4b OCSCC who had undergone surgical treatment. METHODS From 2011 to 2017, a total of 4031 and 355 patients with first primary pT4a and pT4b OCSCC were identified. A propensity score (PS)-matched analysis of patients (n = 351 each) for pT4a and pT4b tumors was also performed. RESULTS The 5-year disease-specific and overall survival (DSS/OS) rates were more favorable in patients with pT4a than in those with pT4b OCSCC (64%/55%, p < 0.0001; 55%/43%, p < 0.0001, respectively). Compared with pT4a, those with pT4b tumors had a higher burden of the following risk factors: buccal/retromolar/hard palate subsite, male sex, depth ≥ 10 mm, and positive margins. Before PS matching, multivariable analyses revealed that pT4b tumors (versus pT4a) were an adverse prognosticator for both 5-year DSS and OS (hazard ratios: 1.32 and 1.39, respectively). However, in the PS-matched cohort, no significant differences in 5-year DSS and OS rates were observed between pT4a and pT4b OCSCC (57%/56%, p = 0.4024; 48%/44%, p = 0.1807, respectively) CONCLUSIONS: No significant outcome differences were evident between pT4b and pT4a OCSCC after PS matching. The most plausible hypothesis for the observed survival difference between T4a and T4b tumors is that it was driven by positive margins. We suggest that T4b OCSCC should undergo initial surgical excision if adequate resection is possible.
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Affiliation(s)
- Chung-Jan Kang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yu-Wen Wen
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan, ROC; Division of Thoracic Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Shu-Ru Lee
- Research Service Center for Health Information, Chang Gung University, Taoyuan Taiwan, ROC
| | - Shu-Hang Ng
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Li-Ang Lee
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Li-Yu Lee
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chuen Hsueh
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chien-Yu Lin
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Kang-Hsing Fan
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Hung-Ming Wang
- Department of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chia-Hsun Hsieh
- Department of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chih-Hua Yeh
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chi-Ying Tsai
- Department of Oral and Maxillofacial Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chih-Hung Lin
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chung-Kan Tsao
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Tuan-Jen Fang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Shiang-Fu Huang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Ku-Hao Fang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yu-Chien Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Wan-Ni Lin
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Li-Jen Hsin
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Tzu-Chen Yen
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Nai-Ming Cheng
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chun-Ta Liao
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
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5
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Parra-Lara LG, Mendoza-Urbano DM, Zambrano ÁR, Valencia-Orozco A, Bravo-Ocaña JC, Bravo-Ocaña LE, Rosso F. Methods and implementation of a Hospital-Based Cancer Registry in a major city in a low-to middle-income country: the case of Cali, Colombia. Cancer Causes Control 2022; 33:381-392. [PMID: 35013914 DOI: 10.1007/s10552-021-01532-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 11/30/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To describe our experience upon developing and implementing a hospital-based cancer registry (HBCR) in a quaternary-level of care private non-profit academic medical center in Cali, Colombia. METHODS HBCRs capture, in a given institution, every single patient with a confirmed malignancy. In this study, all cases evaluated between 2014 and 2018 were included in the HBCR. In compliance with the International Agency for Research on Cancer recommendations, cases were classified as analytic or non-analytic. Data derived from an exhaustive selection of patients was stored in a computing platform owned by the institution, meeting the 2016 Facility Oncology Registry Data Standards recommendations. Quality control was performed by evaluating comparability, timeliness, validity, and completeness. RESULTS A total of 24,405 new cases were registered between 2014 and 2018, from which 4253 (17.4%) died. Among all cases, based on the anatomic location, most common malignancies were breast (n = 1554), thyroid (n = 1346), hematolymphoid (n = 1251), prostatic (n = 805), and colorectal (n = 624). The behavior of the new cases was consistent with an incremental trend. CONCLUSION Upon implementing the HBCR, major challenges were identified (i.e., a precise definition of cases, the development of processes for capturing new cases, a standardized data collection strategy, and carrying-out an appropriate patient follow-up). Based on our experience, the success of an HBCR largely relies on the interest from the institution, the engagement of stakeholders and financial support, that is, it depends on the adequate access over time to funding, technological, and staffing resources.
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Affiliation(s)
- Luis G Parra-Lara
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cra 98 No. 18-49, 760032, Cali, Colombia. .,Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, 760031, Cali, Colombia.
| | - Diana M Mendoza-Urbano
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cra 98 No. 18-49, 760032, Cali, Colombia
| | - Ángela R Zambrano
- Servicio de Hemato-Oncología, Departamento de Medicina Interna, Fundación Valle del Lili, Cra 98 No. 18-49, 760032, Cali, Colombia
| | - Andrea Valencia-Orozco
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cra 98 No. 18-49, 760032, Cali, Colombia
| | - Juan C Bravo-Ocaña
- Departamento de Patología y Laboratorio Clínico, Fundación Valle del Lili, Cra 98 No. 18-49, 760032, Cali, Colombia
| | - Luis E Bravo-Ocaña
- Registro Poblacional de Cáncer de Cali, Departamento de Patología, Facultad de Salud, Universidad del Valle, 760032, Cali, Colombia
| | - Fernando Rosso
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cra 98 No. 18-49, 760032, Cali, Colombia.,Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, 760031, Cali, Colombia.,Servicio de Infectología, Departamento de Medicina Interna, Fundación Valle del Lili, Cra 98 No. 18-49, 760032, Cali, Colombia
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6
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Pukkala E, Peltomaa M, Mäkitie A, Heikkinen S, Kjærheim K, Martinsen JI, Sparén P, Tryggvadottir L, Weiderpass E. Cancer incidence among musicians: 45 years of follow-up in four Nordic countries. Acta Oncol 2021; 60:835-841. [PMID: 34162315 DOI: 10.1080/0284186x.2021.1924403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/27/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND There are studies suggesting that participation in musical activities may protect from cancer. On the other hand, some musicians have a lifestyle that might increase the risk of cancer. The objective of this study was to assess the cancer pattern of musicians in four Nordic countries. MATERIAL AND METHODS This study combines census and cancer registry data from 1961 to 2005 for 13 million people from Finland, Iceland, Norway, and Sweden. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for entire national populations used as reference rates. RESULTS There were 11,401 male and 3105 female musicians with 2039 cancer cases. The SIR for all sites combined was 1.02 (95% confidence interval 0.97-1.07) in men and 1.04 (0.94-1.15) in women. In male musicians, there were statistically significant excesses in oropharyngeal cancer (4.36, 2.73-6.60), esophageal cancer (2.08, 1.51-2.81), liver cancer (1.81, 1.26-2.52), and skin melanoma (1.40, 1.10-1.75). The risk was decreased in lip cancer (0.13, 0.02-0.48), stomach cancer (0.66, 0.50-0.82), and lung cancer (0.77, 0.65-0.90). In female musicians, there were no statistically significant SIRs in any of the cancer types studied, but the risk of breast cancer was significantly elevated in the age category of 70+ (1.52, 1.04-2.15). The overall SIR was stable over the 45 year period of observation, but strong decreases were observed in the SIRs of esophageal cancer, liver cancer, laryngeal cancer, and skin melanoma. CONCLUSION Musicians have characteristics of indoor workers such as low incidence of lip cancer and high incidence of skin melanoma. The low incidence of lung cancer suggests that the prevalence of smoking among musicians is lower than in the general population while the elevated risk of alcohol-related cancer types suggest that drinking is likely more common among musicians. The cancer risk for all sites combined is still similar to that of the general population in the four countries studied.
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Affiliation(s)
- Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Miikka Peltomaa
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Musician Clinic, Helsinki Music Hall, Helsinki, Finland
- Sibelius Academy, University of the Arts, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Clinical Sciences, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sanna Heikkinen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | | | | | - Pär Sparén
- Karolinska Institutet, Stockholm, Sweden
| | - Laufey Tryggvadottir
- Icelandic Cancer Registry, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Elisabete Weiderpass
- International Agency for Research on Cancer/World Health Organization (IARC/WHO), Lyon, France
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7
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Tsai CY, Lee SR, Lee LY, Hsueh C, Lin CY, Fan KH, Wang HM, Hsieh CH, Ng SH, Yeh CH, Lin CH, Tsao CK, Fang TJ, Huang SF, Lee LA, Kang CJ, Fang KH, Wang YC, Lin WN, Hsin LJ, Yen TC, Cheng NM, Wen YW, Liao CT. Clinical outcomes of Taiwanese patients with resected squamous cell carcinoma of the upper and lower gum. Oral Oncol 2021; 118:105334. [PMID: 34020150 DOI: 10.1016/j.oraloncology.2021.105334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/07/2021] [Accepted: 05/05/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This large-scale cohort study was designed to compare the clinical outcomes of Taiwanese patients with squamous cell carcinoma (SCC) of the upper versus lower gum. METHODS Between 2004 and 2017, we identified 4244 patients with first primary SCC of the gum (694 upper gum; 3550 lower gum) who were treated with surgery either with or without adjuvant therapy. Of them, 1990 patients (329 upper gum; 1661 lower gum) enrolled from 2011 to 2017 had a higher number of histopathological variables and entered subgroup analyses. Five-year disease-specific survival (DSS) and overall survival (OS) rates served as outcome measures. RESULTS The 5-year DSS and OS rates of patients with upper gum SCC were lower than those of cases with lower gum SCC (65%/74%, p < 0.0001; and 55%/65%, respectively, p < 0.0001). Compared with lower gum SCC, upper gum SCC had a higher prevalence of the following variables: female sex, age ≥ 65 years, pNx (without neck dissection), no-betel chewing (2011-2017), no-smoking (2011-2017), and margin status ≤ 4 mm (positive and close margins, 2011-2017). On multivariable analysis, gum subsite (upper versus lower), age (≥65 versus < 65 years), pT (T3 - 4 versus T1 - 2), pN (N1 - 3 versus N0/Nx), depth (≥10 mm versus < 10 mm, 2011-2017), ENE (present versus absent, 2011-2017), and margins (≤4 mm versus > 4 mm 2011-2017, only DSS) were identified as independent adverse prognostic factors for 5-year DSS and OS. CONCLUSIONS Compared to lower gum SCC, upper gum SCC had less favorable 5-year outcomes. Wide resection margins are recommended to improve prognosis of upper gum SCC.
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Affiliation(s)
- Chi-Ying Tsai
- Department of Oral and Maxillofacial Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Shu Ru Lee
- Research Service Center for Health Information, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Li-Yu Lee
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chuen Hsueh
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chien-Yu Lin
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Kang-Hsing Fan
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Hung-Ming Wang
- Department of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chia-Hsun Hsieh
- Department of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Shu-Hang Ng
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chih-Hua Yeh
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chih-Hung Lin
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chung-Kan Tsao
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Tuan-Jen Fang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Shiang-Fu Huang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Li-Ang Lee
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chung-Jan Kang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Ku-Hao Fang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yu-Chien Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Wan-Ni Lin
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Li-Jen Hsin
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Tzu-Chen Yen
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Nai-Min Cheng
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yu-Wen Wen
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan, ROC.
| | - Chun-Ta Liao
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
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Zadnik V, Zagar T, Lokar K, Tomsic S, Konjevic AD, Zakotnik B. Trends in population-based cancer survival in Slovenia. Radiol Oncol 2021; 55:42-9. [PMID: 33885247 DOI: 10.2478/raon-2021-0003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 01/10/2021] [Indexed: 11/21/2022] Open
Abstract
Background The aim of our study was to describe the survival of Slovenian cancer patients diagnosed in the last twenty years. An insight is given into the improvement made in different cancer types, population groups and prognostic factors. Materials and methods The principal data source was the population-based Slovenian Cancer Registry. The survival analysis included patients diagnosed with cancer in twenty years period from 1997 to 2016, which has been divided into four consecutive five-year periods. In addition, the analysis was stratified by cancer type, gender, age and stage. The survival was estimated using net survival calculated by the Pohar-Perme method and the complete approach has been applied. Results The survival of Slovenian cancer patients has been increasing over time. During the 20 years observed, five-year net survival increased by 11 percentage points. Significantly higher growth was observed in men. Age and stage at diagnosis are still crucial for the survival of cancer patients. Five-year net survival is lowest in those over 75 years of age at diagnosis but has also improved by seven percentage points over the past 20 years. The five-year net survival of patients in the localized stage increased by ten percentage points over the 20 years under observation. Survival of patients in the distant stage has not been improving. In both sexes, survival for melanoma, colorectal and lung cancers have increased significantly over the last 20 years. Progress has also been made in the two most common gender specific cancers: breast cancer in women and prostate cancer in men. Still, the significant progress in prostate cancer is probably mostly due to lead-time bias as during the study period, Slovenia used indiscriminate PSA testing, which probably artificially prolonged survival. Conclusions The survival of Slovenian cancer patients has been increasing over time, which gives us a basis and an incentive for future improvements. To monitor the effectiveness of managing the cancer epidemic, the cancer burden needs to be monitored also in the future, using quality data and scientifically justified methodological approaches. In this process a well organised population-based cancer registries should play a key role.
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Cogle CR, Levin G, Lee DJ, Peace S, Herna MC, MacKinnon J, Gwede CK, Philip C, Hylton T. Finding incident cancer cases through outpatient oncology clinic claims data and integration into a state cancer registry. Cancer Causes Control 2020; 32:199-202. [PMID: 33222075 DOI: 10.1007/s10552-020-01368-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 11/11/2020] [Indexed: 10/22/2022]
Abstract
Cancer data from population-based cancer registries under-report cancer cases, especially for cancers primarily diagnosed and treated in outpatient clinical settings, away from hospital-based cancer registrars. Previously, we developed alternative methods of cancer case capture including a claims-based method, which identified a large proportion of cancer cases missed by traditional population-based cancer registries. In this study, we adapted a claims-based method for statewide implementation of cancer surveillance in Florida. Between 2010 and 2017 the claims-based method identified 143,083 cancer abstracts, of which 42% were new and 58% were previously registered. The claims-based method led to the creation of 53,419 new cancer cases in the state cancer registry, which made up 9.3% of all cancer cases registered between 2010 and 2017. The types of cancers identified by the claims-based method were typical of the kinds primarily diagnosed and treated in outpatient oncology clinic settings, such as hematological malignancies, prostate cancer, melanoma, breast cancer, and bladder cancer. These cases were added to the Florida cancer registry and may produce an artefactual increase in cancer incidence, which is believed to be closer to the actual burden of cancer in the state.
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Affiliation(s)
- Christopher R Cogle
- Division of Hematology and Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
| | - Gary Levin
- Florida Cancer Data System, Miami, FL, USA
| | | | | | | | | | | | | | - Tara Hylton
- Florida Department of Health, Tallahassee, FL, USA
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10
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Abstract
Introduction Timeliness of data availability is a key performance measure in cancer
reporting. Previous studies evaluated timeliness of cancer reporting using a
single metric, yet this metric obscures the details within each step of the
reporting process. To enhance understanding of cancer reporting processes,
we measured the timeliness of discrete cancer reporting steps and examined
changes in timeliness across a decade. Methods We analyzed 76,259 cases of breast, colorectal and lung cancer reported to
the Indiana State Cancer Registry between 2001 and 2011. We measured
timeliness for three fundamental reporting steps: report completion time,
report submission time, and report processing time. Timeliness was measured
as the difference, in days, between timestamps recorded in the cancer
registry at each step. We further examined the variation in reporting time
among facilities. Results Identifying and gathering details about cases (report completion) accounts
for the largest proportion of time during the cancer reporting process.
Although submission time accounts for a lesser proportion of time, there is
wide variation among facilities. One-seventh (7 out of 49) facilities
accounted for 28.4% of the total cases reported, all of which took more than
100 days to submit the completed cases to the registry. Conclusions Measuring timeliness of the individual steps in reporting processes can
enable cancer registry programs to target individual facilities as well as
tasks that could be improved to reduce overall case reporting times. Process
improvement could strengthen cancer control programs and enable more rapid
discovery in cancer research.
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11
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Chakraborty D, Rangamani S, Kulothungan V, Chaturvedi M, Stephen S, Das P, Sudarshan KL, Janani Surya R, Sathish Kumar K, John A, Manoharan N, Koyande SS, Swaminathan R, Ramesh C, Shrivastava A, Ganesh B, Mathur P, Nandakumar A. Trends in incidence of Ewing sarcoma of bone in India - Evidence from the National Cancer Registry Programme (1982-2011). J Bone Oncol 2018; 12:49-53. [PMID: 30237969 PMCID: PMC6142187 DOI: 10.1016/j.jbo.2018.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/05/2018] [Accepted: 04/05/2018] [Indexed: 11/24/2022] Open
Abstract
Background Ewing sarcoma is a malignant tumour found mainly in childhood and adolescence. The present study aims at analyzing the data on Ewing sarcoma cases of bone from the National Cancer Registry Programme, India to provide incidence, patterns, and trends in the Indian population. Materials and Methods The data of five Population Based Cancer Registries (PBCR) of Bangalore, Mumbai, Chennai, Bhopal and Delhi over 30 years period (1982- 2011) were used to calculate the Age Specific and Age Standardized Incidence Rates (ASpR and ASIR), and trends in incidence was analyzed by linear and Joinpoint Regression. Results Ewing sarcoma comprised around 15 % of all bone malignancies. Sixty-eight percent were 0-19 years, with 1.6 times risk of tumour in bones of limbs as compared to other bones. The highest incidence rate (per million) was in the 10-14 years age group (male -4.4, female -2.9) with significantly increasing trend in ASpR observed in both sexes. Pooled ASIR per million for all ages was higher in male (1.6) than female (1.0) with an increasing rate ratio of ASIR with increase in age. Trend of pooled ASIR for all ages was significantly increased in both sexes. Twelve percent cases were reported in ≥30 years of age. Conclusion This paper has described population based measurements on burden and trends in incidence of skeletal Ewing in India. These may steer further research questions on the clinical and molecular epidemiology to explain factors associated with the increasing incidence of Ewing sarcoma bone observed in India.
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Affiliation(s)
- Debjit Chakraborty
- National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR), Bengaluru, India
| | - Sukanya Rangamani
- National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR), Bengaluru, India
| | - Vaitheeswaran Kulothungan
- National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR), Bengaluru, India
| | - Meesha Chaturvedi
- National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR), Bengaluru, India
| | - S Stephen
- National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR), Bengaluru, India
| | - Priyanka Das
- National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR), Bengaluru, India
| | | | - R Janani Surya
- National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR), Bengaluru, India
| | - K Sathish Kumar
- National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR), Bengaluru, India
| | - Anish John
- National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR), Bengaluru, India
| | - N Manoharan
- Population Based Cancer Registry, Institute of Rotary Cancer Hospital and All India Institute of Medical Sciences, New Delhi, India
| | - S S Koyande
- Mumbai Cancer Registry, Indian Cancer Society, Mumbai, India
| | - Rajaraman Swaminathan
- Department of Biostatistics and Cancer Registry, Cancer Institute (WIA), Chennai, India
| | - C Ramesh
- Department of Epidemiology and Biostatistics, Kidwai Memorial Institute of Oncology, Bengaluru, India
| | - Atul Shrivastava
- Population Based Cancer Registry, Department of Pathology, Gandhi Medical College, Bhopal, India
| | - B Ganesh
- Department of Epidemiology and Biostatistics, Tata Memorial Hospital, Mumbai, India
| | - Prashant Mathur
- National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR), Bengaluru, India
| | - Ambakumar Nandakumar
- National Centre for Disease Informatics and Research (NCDIR), Indian Council of Medical Research (ICMR), Bengaluru, India
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Abstract
In this article we provide an overview of the Canadian healthcare system and the cancer care system in Canada as it pertains to the governance, funding and delivery of radiotherapy programmes. We also review the training and practice for radiation oncologists, medical physicists and radiation therapists in Canada. We describe the clinical practice of radiation medicine from patients' referral, assessment, case conferences and the radiotherapy process. Finally, we provide an overview of the practice culture for Radiation Oncology in Canada.
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Affiliation(s)
- Meredith Giuliani
- Radiation Medicine Program, Princess Margaret Cancer Centre.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Mary Gospodarowicz
- Radiation Medicine Program, Princess Margaret Cancer Centre.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
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13
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Liao CT, Wen YW, Yang LY, Lee SR, Ng SH, Liu TW, Tsai ST, Tsai MH, Lin JC, Chen PR, Lou PJ, Wang CP, Chu PY, Hwang TZ, Leu YS, Tsai KY, Terng SD, Chen TM, Wang CH, Chien CY, Chen WC, Lee LY, Lin CY, Wang HM, Hsieh CH, Tsao CK, Fang TJ, Huang SF, Kang CJ, Chang KP, Yen TC. Comparative clinical outcomes of Taiwanese patients with resected buccal and tongue squamous cell carcinomas. Oral Oncol 2017; 67:95-102. [PMID: 28351587 DOI: 10.1016/j.oraloncology.2017.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/26/2017] [Accepted: 02/12/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Although patients with buccal squamous cell carcinoma (SCC) usually show acceptable outcomes, local control and survival rates are generally lower than those observed for tongue SCC. This study was designed to compare the clinical outcomes of Taiwanese patients with these two common oral cavity malignancies. METHODS Patients with first primary buccal or tongue SCC who were included in the Taiwanese Cancer Registry Database between 2004 and 2012 were eligible. The study sample consisted of 16,379 patients (7870 buccal SCC and 8509 tongue SCC) who received surgery with or without adjuvant therapy. The 5-year disease-specific survival (DSS) and overall survival (OS) rates served as the outcome measures. RESULTS Compared with tongue SCC, patients with buccal SCC had a higher prevalence of males (95.7% vs. 86.4%, p<0.0001), pT4 disease (21.4% vs. 12.7%, p<0.0001), and p-Stage IV (30.4% vs. 24.8%, p<0.0001) but a lower frequency of pN2 disease (15.2% vs. 18.5%, p<0.0001). The 5-year DSS and OS rates of buccal SCC patients were slightly higher than those of tongue SCC (78% vs. 77%, p=0.0297; and 71% vs. 69%, p=0.0231, respectively). Multivariate analysis identified tumor site (tongue vs. buccal SCC), sex (male vs. female), age (≥65 vs. <65years), pT classification (T4/T3/T2 vs. T1), and pN classification (N3/N2/N1vs. N0) as independent prognostic factors in the entire study cohort. CONCLUSIONS The survival advantage of buccal SCC over tongue SCC appears significant in large clinical samples, despite a higher prevalence of p-Stage IV disease in the former.
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Jung KW, Won YJ, Kong HJ, Oh CM, Shin A, Lee JS. Survival of korean adult cancer patients by stage at diagnosis, 2006-2010: national cancer registry study. Cancer Res Treat 2013; 45:162-71. [PMID: 24155674 PMCID: PMC3804727 DOI: 10.4143/crt.2013.45.3.162] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 08/13/2013] [Indexed: 12/27/2022] Open
Abstract
Purpose Although the cancer stage at diagnosis is the most important prognostic factor for patients' survival, there are few population-based estimates of stage-specific survival outcome, especially in Asian countries. Our study aims to estimate stage-specific survival for Korean patients. Materials and Methods We analyzed the Korea National Cancer Incidence Database data on 626,506 adult patients aged ≥ 20 years, who were diagnosed between 2006 and 2010 with stomach, colorectal, liver, lung, breast, cervix, prostate, and thyroid cancers. Patients were followed up to December 2011, and the 5-year relative survival rates (RSRs) were calculated for gender and age group by Surveillance, Epidemiology, and End Results (SEER) stage at diagnosis. Results The 5-year RSRs for all localized-stage cancers, except for lung and liver, exceeded 90% with that for thyroid cancer being the highest at 100.4%. These values for distant stage liver, lung, and stomach cancers were very dismal at 2.5%, 4.8%, and 5.5%, respectively, while it was 69.1% for thyroid cancer, and was in the range of 18.3-36.4% for colorectal, cervix, breast and prostate cancers. Overall, the 5-year RSRs for all cancer types decreased with aging across all the disease stages with exception of prostate cancer, which suggests biologic difference in these cancer types in a young age group. When compared with US SEER data, Korean patients had better stage-specific survival rates for stomach, colorectal, liver, and cervical cancers. Conclusion Korean cancer patients showed relatively favorable stage distribution and 5-year RSRs, which suggests potential contribution of the national cancer screening program.
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Affiliation(s)
- Kyu-Won Jung
- The Korea Central Cancer Registry, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
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15
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Zucchetto A, Ronco G, Giorgi Rossi P, Zappa M, Ferretti S, Franzo A, Falcini F, Visioli CB, Zanetti R, Biavati P, La Rosa F, Baracco S, Federico M, Campari C, De Togni A, Piffer S, Pannozzo F, Fusco M, Michiara M, Castaing M, Seghini P, Tisano F, Serraino D. Screening patterns within organized programs and survival of Italian women with invasive cervical cancer. Prev Med 2013; 57:220-6. [PMID: 23732239 DOI: 10.1016/j.ypmed.2013.05.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 05/03/2013] [Accepted: 05/27/2013] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate screening patterns within organized cervical screening programs (OCSPs) and survival of women with invasive cervical cancer (ICC). METHODS A population-based study was conducted in Italian areas covered by cancer registries and OCSPs. The study included all women aged 25-65 years diagnosed with ICC between 1995 and 2008, and their screening histories within OCSPs were retrieved. Hazard ratios (HR) of death and 95% confidence intervals (CI) were computed according to screening pattern, using Cox models adjusted for age, ICC stage, and major confounders. RESULTS Among 3268 women with ICC, 20% were never-invited to OCSP, 36% were never-compliant with OCSP's invitation, 33% were compliant and had a screen-detected ICC within OCSP (i.e., after a positive cytology), and 11% were compliant but had a non-screen-detected ICC. Screen-detected ICCs were more frequently micro-invasive (42%) compared to non-screen-detected ones (14%). Compared to women with screen-detected ICC, the adjusted HRs of death were 1.9 (95% CI 1.5-2.4) for those never-invited, 2.0 (95% CI 1.6-2.5) for never-compliant, and 1.7 (95% CI 1.3-2.4) for compliant women having non-screen-detected ICC. CONCLUSION Prolonged survival, beyond down-staging, of women with ICC detected within OCSPs in Italy, further calls for improvements of OCSPs' invitational coverage and participation.
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Affiliation(s)
- Antonella Zucchetto
- Epidemiology and Biostatistics Unit, Aviano National Cancer Institute Centro di riferimento oncologico, Via Gallini 2, 33081 Aviano (PN), Italy.
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16
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Abstract
BACKGROUND Cancer monitoring and prevention relies on the critical aspect of timely notification of cancer cases. However, the abstraction and classification of cancer from the free-text of pathology reports and other relevant documents, such as death certificates, exist as complex and time-consuming activities. AIMS In this paper, approaches for the automatic detection of notifiable cancer cases as the cause of death from free-text death certificates supplied to Cancer Registries are investigated. METHOD A number of machine learning classifiers were studied. Features were extracted using natural language techniques and the Medtex toolkit. The numerous features encompassed stemmed words, bi-grams, and concepts from the SNOMED CT medical terminology. The baseline consisted of a keyword spotter using keywords extracted from the long description of ICD-10 cancer related codes. RESULTS Death certificates with notifiable cancer listed as the cause of death can be effectively identified with the methods studied in this paper. A Support Vector Machine (SVM) classifier achieved best performance with an overall Fmeasure of 0.9866 when evaluated on a set of 5,000 freetext death certificates using the token stem feature set. The SNOMED CT concept plus token stem feature set reached the lowest variance (0.0032) and false negative rate (0.0297) while achieving an F-measure of 0.9864. The SVM classifier accounts for the first 18 of the top 40 evaluated runs, and entails the most robust classifier with a variance of 0.001141, half the variance of the other classifiers. CONCLUSION The selection of features significantly produced the most influences on the performance of the classifiers, although the type of classifier employed also affects performance. In contrast, the feature weighting schema created a negligible effect on performance. Specifically, it is found that stemmed tokens with or without SNOMED CT concepts create the most effective feature when combined with an SVM classifier.
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Affiliation(s)
- Luke Butt
- The Australian e-Health Research Centre, Brisbane, Queensland, Australia
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Ghaneie M, Rezaie A, Ghorbani NR, Heidari RN, Arjomandi M, Zare M. Designing a minimum data set for breast cancer: a starting point for breast cancer registration in iran. Iran J Public Health 2013; 42:66-73. [PMID: 23865019 PMCID: PMC3712595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 09/16/2012] [Indexed: 11/06/2022]
Abstract
BACKGROUND Due to the high incidence of deaths from breast cancer, high cost of treatment and limited resources, the need to formulate and implement effective programs in reducing the burden of disease is obvious. Care, control and creation of cancer information system having an infrastructure from collection of minimum data sets (MDS) are the top priorities of research in Iran's Ministry of Health. METHODS This is an applied descriptive research with comparative approach implemented in 2010. MDS for breast cancer on selected countries were searched and reviewed and proposed model based on the country's need was designed. Research data were implemented in 2 stages; assessment of MDS on selected countries and the validation of the proposed model through several meetings that has been carried out by the Undersecretary for Research and Technology and several oncologists and pathologists. RESULTS The MDS is composed of 11 parameters in the form of fields in closed structured arrangements with consideration to coding responses. These parameters include: hospital data, demography, referral, physical examination and investigation, diagnostic information, pathology, treatment, palliative care, completion of primary treatment, clinical trials and follow-up. This form is available for use in the cancer registry database. CONCLUSION MDS provides an opportunity to strengthen communication between performed researches and research results for the improvement of programs, policies and strategies and provides positive effect on equality in the health system. Although the stages of creating the MDS for breast cancer has been successful, but many challenges has been met until its completion.
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Affiliation(s)
- M Ghaneie
- Deputy of Research & Technology, Ministry of Health, Treatment and Medical Education, Tehran, Iran
| | - A Rezaie
- Deputy of Research & Technology, Ministry of Health, Treatment and Medical Education, Tehran, Iran
| | - N R Ghorbani
- Deputy of Research & Technology, Ministry of Health, Treatment and Medical Education, Tehran, Iran,Dept. of Health Information Management, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author:
| | - RN Heidari
- Deputy of Research & Technology, Ministry of Health, Treatment and Medical Education, Tehran, Iran
| | - M Arjomandi
- Deputy of Research & Technology, Ministry of Health, Treatment and Medical Education, Tehran, Iran
| | - M Zare
- Deputy of Research & Technology, Ministry of Health, Treatment and Medical Education, Tehran, Iran
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