Epidemiology, Diagnosis and Survival of Breast Cancer: Data from the Population-Based Cancer Registry of the City of Parakou from 2017 to 2021

Background: Breast cancer mortality remains high in the majority of developing countries. The Ministry of Health has established two population-based cancer registries in Benin: the first one in Cotonou in 2014 and the second one in Parakou in 2017. However, there is a scarcity of data on breast cancer survival and prognosis in Benin Republic. Objective: This study sought to investigate epidemiological, diagnostic, and survival aspects of breast cancer in Parakou, based on data from its population-based cancer registry from 2017 to 2021. Method: For descriptive and analytical purposes, we used a retrospective cohort design. From January 24, 2022 to August 31, 2022, data were collected in all health facilities covered by the Parakou population-based cancer registry using an individual questionnaire. Survival and prognosis analysis were performed using KAPLAN MEIER method and David COX proportional hazard model respectively. Result: A total of 81 patients have been included in this study. The incidence rate of breast cancer in Parakou was 17.5 per 100,000 person-years with a mortality rate of 2.76 per 100,000 person-years. The median age at diagnosis was 44.50 years with extremes ranging from 19 to 76 years and a predominance of 40 - 50 years age group. The median survival time was estimated at 30 months with an overall 5-year survival of 47%. Young age at diagnosis (p-value = 0.002) and advanced stage at diagnosis (p-value = 0.000) had a negative impact on survival in women. The combination of surgery and chemotherapy improved survival (p-value = 0.018). Conclusion: Breast cancer is still a public health issue in Parakou. It comes out mandatory that resources be made available to make screening, early diagnosis and appropriate treatment of breast cancer affordable.

Secular decreasing trends in gastric cancer incidence in Taiwan:A population-based cancer registry study

BACKGROUND Gastric cancer remains a leading cause of cancer death worldwide.In Taiwan,gastric cancer is the sixth leading cause of cancer mortality in both males and females.AIM To evaluate secular trends in gastric cancer incidence according to age,sex,and Helicobacter pylori(H.pylori)treatment in Taiwan.METHODS In this population-based study,we used the national Taiwan Cancer Registry database.Annual percent changes in incidence rates were used to describe secular trends in incidence rates and sex ratios of gastric cancer in Taiwan.Pearson’s product-moment correlation coefficients were used to analyze the correlation between annual age-adjusted incidence rates and the annual number of patients treated with antibiotic therapy for H.pylori infection.RESULTS The annual percent changes showed continuously decreasing rates of gastric cancer among both males and females.However,the decreasing trends differed by sex,with an annual percent change of-2.58%in males and-2.14%in females.The age-specific incidence rates increased with age.Within the same age group,more recent time periods showed lower incidence rates than greater time periods.Similarly,the sex ratio was lower in later birth cohorts than in earlier birth cohorts.Age-adjusted incidence rates substantially decreased with increasing numbers of patients being treated with antibiotic therapy for H.pylori infection during 2005 to 2016(r=0.72).CONCLUSION We observed steadily decreasing trends with differential sex ratios in the incidence of gastric cancer in Taiwan.These results support H.pylori eradication programs in Taiwan.

Synergetic role of integrating the departments of cancer registry and clinical research at an academic comprehensive cancer center

Integration of the cancer registry and clinical research departments can have a significant impact on the accreditation process of a Commission on Cancer(Co C) Program.Here in we demonstrate that the integration of both departments will benefit as there is increased knowledge, manpower and crossover in job responsibilities in our Co C-accredited Academic Comprehensive Cancer Center.In our model this integration has led to a more successful cooperative interaction among departments, which has in turn created an enhanced combined effect on overall output and productivity.More manpower for the cancer registry has led to increased caseloads, decreased time from date of first contact to abstraction, quality of data submissions, and timely follow-up of all patients from our reference date for accurate survival analysis along with completeness of data.In 2016, our Annual Facility report showed an additional 163 cases over prediction by the state of Maryland Cancer Registry and a 39% increase in case completeness.As proof of the synergetic effectiveness of our model within one year of its implementation, the cancer center was able to apply for, and was awarded membership from Alliance for Clinical Trials in Oncology, Central IRB, and in turn led to increased clinical trial accrual from 2.8% in 2014 compared to 13.2% currently.Our cancer registry in year one submitted over 150 more cases than predicted, improved quality outcome measures displayed by our Cancer Program Practice Profile reports and had more timely and complete data submissions to national and state registries.This synergetic integration has led to a better understanding, utilization and analysis of data by an integrated team with Clinical Research expertise.

Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?

BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor prognoses.The efficacy of CRC screening has been well-established;nevertheless,a significant proportion of patients remain unscreened,with>70%of cases diagnosed outside screening.Although identifying specific subgroups for whom CRC screening should be particularly recommended is crucial owing to limited resources,the association between the diagnostic routes and identification of these subgroups has been less appreciated.In the Japanese cancer registry,the diagnostic routes for groups discovered outside of screening are primarily categorized into those with comorbidities found during hospital visits and those with CRC-related symptoms.AIM To clarify the stage at CRC diagnosis based on diagnostic routes.METHODS We conducted a retrospective observational study using a cancer registry of patients with CRC between January 2016 and December 2019 at two hospitals.The diagnostic routes were primarily classified into three groups:Cancer screening,follow-up,and symptomatic.The early-stage was defined as Stages 0 or I.Multivariate and univariate logistic regressions were exploited to determine the odds of early-stage diagnosis in the symptomatic and cancer screening groups,referencing the follow-up group.The adjusted covariates were age,sex,and tumor location.RESULTS Of the 2083 patients,715(34.4%),1064(51.1%),and 304(14.6%)belonged to the follow-up,symptomatic,and cancer screening groups,respectively.Among the 2083 patients,CRCs diagnosed at an early stage were 57.3%(410 of 715),23.9%(254 of 1064),and 59.5%(181 of 304)in the follow-up,symptomatic,and cancer screening groups,respectively.The symptomatic group exhibited a lower likelihood of early-stage diagnosis than the follow-up group[P<0.001,adjusted odds ratio(aOR),0.23;95%confidence interval(95%CI):0.19-0.29].The likelihood of diagnosis at an early stage was similar between the follow-up and cancer screening groups(P=0.493,aOR for early-stage diagnosis in the cancer screening group vs follow-up group=1.11;95%CI=0.82-1.49).CONCLUSION CRCs detected during hospital visits for comorbidities were diagnosed earlier,similar to cancer screening.CRC screening should be recommended,particularly for patients without periodical hospital visits for comorbidities.

Global patterns of breast cancer incidence and mortality:A population-based cancer registry data analysis from 2000 to 2020

Background:Breast cancer is the most commonly diagnosed cancer and leading cause of cancer death among women worldwide but has patterns and trends which vary in different countries.This study aimed to evaluate the global patterns of breast cancer incidence and mortality and analyze its temporal trends for breast cancer prevention and control.Methods:Breast cancer incidence and mortality data in 2020 were obtained from the GLOBOCAN online database.Continued data from the Cancer Incidence in Five Continents Time Trends,the International Agency for Research on cancer mortality and China National Central Cancer Registry were used to analyze the time trends from 2000 to 2015 through Joinpoint regression,and annual average percent changes of breast cancer incidence and mortality were calculated.Association between Human Development Index and breast cancer incidence and mortality were estimated by linear regression.Results:There were approximately 2.3 million new breast cancer cases and 685,000 breast cancer deaths worldwide in 2020.Its incidence and mortality varied among countries,with the age-standardized incidence ranging from the highest of 112.3 per 100,000 population in Belgium to the lowest of 35.8 per 100,000 population in Iran,and the age-standardized mortality from the highest of 41.0 per 100,000 population in Fiji to the lowest of 6.4 per 100,000 population in South Korea.The peak age of breast cancer in some Asian and African countries were over 10 years earlier than in European or American countries.As for the trends of breast cancer,the age-standardized incidence rates significantly increased in China and South Korea but decreased in the United States of America(USA)during 2000-2012.Meanwhile,the age-standardized mortality rates significantly increased in China and South Korea but decreased in the United Kingdom,the USA,and Australia during 2000 and 2015.Conclusions:The global burden of breast cancer is rising fast and varies greatly among countries.The incidence and mortality rates of breast cancer increased rapidly in China and South Korea but decreased in the USA.Increased health awareness,effective prevention strategies,and improved access to medical treatment are extremely important to curb the snowballing breast cancer burden,especially in the most affected countries.

Breast cancer incidence and mortality in women in China: temporal trends and projections to 2030

Objective:Breast cancer was the most common cancer and the fifth cause of cancer deaths among women in China in 2015.The evaluation of the long-term incidence and mortality trends and the prediction of the future burden of breast cancer could provide valuable information for developing prevention and control strategies.Methods:The burden of breast cancer in China in 2015 was estimated by using qualified data from 368 cancer registries from the National Central Cancer Registry.Incident cases and deaths in 22 cancer registries were used to assess the time trends from 2000 to 2015.A Bayesian age-period-cohort model was used to project the burden of breast cancer to 2030.Results:Approximately 303,600 new cases of breast cancer(205,100 from urban areas and 98,500 from rural areas)and 70,400 breast cancer deaths(45,100 from urban areas and 24,500 from rural areas)occurred in China in 2015.Urban regions of China had the highest incidence and mortality rates.The most common histological subtype of breast cancer was invasive ductal carcinoma,followed by invasive lobular carcinoma.The age-standardized incidence and mortality rates increased by 3.3%and 1.0%per year during 2000–2015,and were projected to increase by more than 11%until 2030.Changes in risk and demographic factors between 2015 and 2030 in cases are predicted to increase by approximately 13.3%and 22.9%,whereas deaths are predicted to increase by 13.1%and 40.9%,respectively.Conclusions:The incidence and mortality of breast cancer continue to increase in China.There are no signs that this trend will stop by 2030,particularly in rural areas.Effective breast cancer prevention strategies are therefore urgently needed in China.

Breast and Ovarian Cancer in Young Women of the Arabian Gulf Region: Relationship to Age

It is widely known that cancer is a disease of “old-age”. However available data show that this is not the case for many types of cancers. Incidences of breast and ovarian cancers have varying rates of change with age. Breast cancer data of Arabian-gulf women, show that the incidence rates increase with age and reach a maximum at 39 year. It then declines linearly with age to about 55 years. The rate of increase and its changes with age are similar to those of many other countries. In the premenopausal phase the relationship between incidence and age could be adequately modeled using a linear model for the logarithmic transformations of age and incidence. Similar observations are made for the ovarian cancer incidences. Results: It is shown that the rate of increase in breast and ovarian cancer incidence with respect to age is increasing in the premenopausal ages. Moreover, the burden of the disease with respect to mortality and “Disability Adjusted Life Years” or DALY, varied considerably among the six gulf countries. Conclusions: We conclude, based on the age incidence relationship that the number of cancer cases may double in the next period that follows our study period (1998-2009). Moreover, if the six countries have identical relationship between age and the two types of cancer, there should be an integrated and unified effort to have a common strategy for prevention and control.

Cancer situation in China:what does the China cancer map indicate fromthe first national death survey to the latest cancer registration?

Background:Over the past four decades,the Chinese government has conducted three surveys on the distribution of causes of death and built cancer registration.In order to shine a new light on better cancer prevention strategies in China,we evaluated the profile of cancer mortality over the forty years and analyzed the policies that have been implemented.Methods:We described spatial and temporal changes in both cancer mortality and the ranking of major cancer types in China based on the data collected from three national surveys during 1973-1975,1990-1992,2004-2005,and the latest cancer registration data published by National Central Cancer Registry of China.The mortality data were compared after conversion to age-standardized mortality rates based on the world standard population(Segi’s population).The geographical distribution characteristics were explored by marking hot spots of different cancers on the map of China.Results:From 1973 to 2016,China witnessed an evident decrease in mortality rate of stomach,esophageal,and cervical cancer,while a gradual increase was recorded in lung,colorectal,and female breast cancer.A slight decrease of mortality rate has been observed in liver cancer since 2004.Lung and liver cancer,however,have become the top two leading causes of cancer death for the last twenty years.From the three national surveys,similar profiles of leading causes of cancer death were observed among both urban and rural areas.Lowermortality rates from esophageal and stomach cancer,however,have been demonstrated in urban than in rural areas.Rural areas had similar mortality rates of the five leading causes of cancer death with the small urban areas in 1973-1975.Additionally,rural areas in 2016 also had approximate mortality rates of the five leading causes with urban areas in 2004-2005.Moreover,stomach,esophageal,and liver cancer showed specific geographical distributions.Althoughmortality rates have decreased atmost of the hotspots of these cancers,they were still higher than the national average levels during the same time periods.Conclusions:Building up a strong primary public health system especially among rural areas may be one critical step to reduce cancer burden in China.

Pancreatic cancer survival trends in the US from 2001 to 2014:a CONCORD-3 study

Background:Survival from pancreatic cancer is low worldwide.In the US,the 5-year relative survival has been slightly higher for women,whites and younger patients than for their counterparts,and differences in age and stage at diagnosis[Corrections added Nov 16,2022,after first online publication:a new affiliation is added to Maja Nikšić]may contribute to this pattern.We aimed to examine trends in survival by race,stage,age and sex for adults(15-99 years)diagnosed with pancreatic cancer in the US.Methods:This population-based study included 399,427 adults registered with pancreatic cancer in 41 US state cancer registries during 2001-2014,with followup to December 31,2014.We estimated age-specific and age-standardized net survival at 1 and 5 years.Results:Overall,12.3%of patients were blacks,and 84.2%were whites.About 9.5%of patients were diagnosed with localized disease,but 50.5%were diagnosed at an advanced stage;slightly more among blacks,mainly among men.No substantial changes were seen over time(2001-2003,2004-2008,2009-2014).In general,1-year net survival was higher in whites than in blacks(26.1%vs.22.1%during 2001-2003,35.1%vs.31.4%during 2009-2014).This difference was particularly evident among patients with localized disease(49.6%in whites vs.44.6%in blacks during 2001-2003,60.1%vs.55.3%during 2009-2014).The survival gap between blacks and whites with localized disease was persistent at 5 years after diagnosis,and it widened over time(from 24.0%vs.21.3%during 2001-2003 to 39.7%vs.31.0%during 2009-2014).The survival gap was wider among men than among women.Conclusions:Gaps in 1-and 5-year survival between blacks and whites were persistent throughout 2001-2014,especially for patients diagnosed with a localized tumor,for which surgery is currently the only treatment modality with the potential for cure.

Incidence and mortality of liver cancer in Henan province in 2015

Objective:Liver cancer is one of the most common types of cancer.We aimed to use the cancer registration data in 2015 to estimate the incidence and mortality of liver cancer in Henan province.Methods:The data from 37 population-based cancer registries in Henan province were collected for this study.The pooled data were stratified by area,sex,and age group.New cases of liver cancer and deaths due to the disease were estimated using age-specific rates and provincial population in 2015.All incidence and death rates were age standardized to the 2000 Chinese standard population and Segi's population,which were expressed per 100,000 populations.Results:After clearance and assessment,data from 30 population-based cancer registries(5 in urban and 25 in rural areas)were included in the analysis.All 30 cancer registries encompassed a total population of 23,421,609(3,507,984 in urban and 19,913,625 in rural areas),accounting for 21.84% of the provincial population.The proportion of morphological verification(MV%),percentage of cancer cases identified with death certification only(DCO%),and mortality-to-incidence ratio(M/I)were 38.55%,2.34%,and 0.81,respectively.Approximately 31,639 new cases of liver cancer were diagnosed and 26,057 deaths from liver cancer occurred in Henan in 2015.The crude incidence rate of liver cancer was 27.05/100,000(36.24/100,000 in men and 17.35/100,000 in women).Age-standardized incidence rates by Chinese standard population and world standard population were 21.10/100,000 and 20.95/100,000,respectively.Liver cancer was more common in men than in women.The incidence rates in urban(26.31/100,000)and rural(27.18/100,000)areas were similar.The crude mortality rate of liver cancer was 21.98/100,000(29.33/100,000 in males and 14.22/100,000 in females).Age-standardized mortality rates by Chinese standard population and world standard population were 16.93/100,000 and 16.90/100,000,respectively.There was no distinct difference in mortality rates of liver cancer between urban(22.55/100,000)and rural(21.87/100,000)areas.Conclusions: Liver cancer has posed a heavy burden on people in Henan province. Comprehensive measures should be conductedto prevent the increase in the incidence of liver cancer.