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1.
Chin Med J (Engl) ; 2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-34091519

RESUMEN

BACKGROUND: Functional dyspepsia (FD) has rarely been investigated in areas with a high prevalence of esophageal squamous cell carcinoma (ESCC). This study aims to reveal the epidemiological and clinical features of FD and organic dyspepsia (OD) in such a population. METHODS: A middle-aged and elderly population-based study was conducted in a region with a high incidence of ESCC. All participants completed the Gastroesophageal Reflux Disease Questionnaire and Functional Gastrointestinal Disease Rome III Diagnostic Questionnaire, and they underwent gastroscopy. After exclusion of gastroesophageal reflux disease, uninvestigated dyspepsia (UID) was divided into OD and FD for further analyses. RESULTS: A total of 2916 participants were enrolled from July 2013 to March 2014 in China. We detected 166 UID cases with questionnaires, in which 17 patients with OD and 149 with FD were diagnosed via gastroscopy. OD cases presented as reflux esophagitis (RE), ESCC, and duodenal ulcer. Heartburn (52.94%) and reflux (29.41%) were common in OD, but no symptomatic differences were found between FD and OD. Male sex, low education level, and liquid food were the risk factors for OD, while frequent fresh vegetable consumption was a protective factor. FD included 56 (37.58%) cases of postprandial distress syndrome (PDS), 52 (34.89%) of epigastric pain syndrome (EPS), nine (6.04%) of PDS + EPS, and 32 (21.48%) of FD + functional esophageal disorders. The Helicobacter pylori infection rate in FD patients was not higher than that in the control group (34.23% vs. 42.26%, P = 0.240). Frequent spicy food consumption was associated with PDS (odds ratio [OR]: 2.088, 95% confidence interval [CI]: 1.028-4.243), while consumption of deep well water was protective for PDS (OR: 0.431, 95% CI: 0.251-0.741). CONCLUSIONS: The prevalence of FD was 5.11% in the studied population. Gastroscopy should be prescribed for dyspepsia patients in case that ESCC and RE would be missed in UID cases diagnosed solely by the Rome III questionnaire. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01688908; https://clinicaltrials.gov/ct2/show/record/NCT01688908.

3.
J Surg Res ; 267: 25-36, 2021 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-34126390

RESUMEN

BACKGROUND: This study aimed to determine the disease characteristics and prognosis of patients with primary mediastinal nonseminomas (PMNS) in a Surveillance, Epidemiology, and End Results (SEER) analysis. MATERIALS AND METHODS: Demographic, treatment, and survival outcome data of cases with PMNS from 1975 to 2016 were retrieved. Cases with unknown variables mentioned in the analysis were excluded. Relative statistical methods were applied to analyze clinical characteristics and prognosis. RESULTS: A total of 587 PMNS patients met the selection criteria, 526 of whom were men. The mean age of patients was 28 (1-85) y. A total of 511 PMNS patients had validated subtypes, including 172 mixed germ cell tumors, 117 yolk sac tumors, 111 malignant teratomas, 70 choriocarcinomas, and 41 embryonal carcinomas. Patients with yolk sac tumors had the highest 3-y cancer-specific survival (CSS) rate (66.9%), while those with choriocarcinoma and embryonal carcinoma showed the worst prognosis. Surgery + chemotherapy (46.2%) was the most common and effective treatment for each subtype of PMNS. Multivariate Cox proportional hazards analysis identified embryonal carcinoma, malignant teratoma, choriocarcinoma, tumor size >15 cm, nodal metastasis, and distant stage as risk factors. In contrast, surgery-based care and younger age were protective factors. Propensity score matching analysis revealed significant improvement in the 5-y CSS rate from 35.8% to 60.3% with surgery (P < 0.001). However, radiotherapy (P = 0.436) and chemotherapy (P = 0.978) showed no survival benefits. CONCLUSIONS: 10 percent of the PMNS patients were female. Choriocarcinomas and embryonal carcinomas had the worst prognosis. Surgery was demonstrated to be the only way to prolong survival time. Chemotherapy and radiotherapy had minimal effects on prognosis.

4.
An Sist Sanit Navar ; 0(0)2021 Jun 15.
Artículo en Español | MEDLINE | ID: mdl-34132245

RESUMEN

BACKGROUND: Cutaneous, superficial and or suprafascial leiomyoma are divided into three variants: piloleiomyomas (PL), angioleiomyomas (AL) and genital leiomyomas (GL) that include the vulvar, scrotal and areolar forms. This study set out to establish the clinical and histological characteristics and incidence of each variant, and any likely associations with internal neoplasms. METHODS: A review was carried out of 255 cases of cutaneous leiomyomas diagnosed between 1982 and 2018 at the Pathology departments of three hospitals (Navarra and Alicante). Demographic, clinical, histological and immunohistochemical variables were described and compared. RESULTS: The incidence of PL in Navarra was 4.3 cases per million inhabitants a year, with another 20 cases of AL and 1.4 cases of GL. Cutaneous forms make up approximately 3.5% of the total leiomyomas. The population with PL suffered more frequently from breast cancer (OR?=?4.8; CI 95%: 1.3-17.4; p?=?0.006). Nipple leiomyomas are small, accompanied by localised pain, and are predominantly fascicular or solid, with very infrequent effect on the subcutaneous cellular tissue and scarce atypia. This makes for a contrast with the other GLs, which are medium sized and infrequently painful, predominantly nodular, and frequent effect on the subcutaneous tissue and atypia. CONCLUSIONS: The information provided here about the clinical and histological characteristics of the different varieties of leiomyomas indicate that there is a need to reconsider the classification of nipple leiomyomas outside the group of GLs. An association between PL and breast carcinoma was detected, which needs to be confirmed in future studies so as to determine if this leiomyoma is a risk marker for breast cancer.

5.
Eur J Cancer ; 152: 18-25, 2021 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-34062483

RESUMEN

OBJECTIVES: Cutaneous melanoma (CM) and keratinocyte cancer (KC) cause considerable morbidity and mortality. We analysed long-term trends of CM and KC in different white populations. MATERIAL AND METHODS: Age-standardised (European Standard Population 2013) incidence and mortality rates (ASIR, ASMR) of CM were extracted from cancer registries in Denmark, New Zealand and the US SEER-Database. ASIRs of KC were sourced from registries of the German federal states Saarland and Schleswig-Holstein, and from Scotland. Age-period-cohort models were used to project melanoma incidence trends. RESULTS: In Denmark between 1943 and 2016, melanoma ASIR increased from 1.1 to 46.5 in males, and from 1.0 to 48.5 in females, estimated to reach 60.0 and 73.1 in males and females by 2036. Melanoma mortality in Denmark (1951-2016) increased from 1.4 to 6.7 (males) and 1.2 to 3.7 (females). In New Zealand between 1948 and 2016, ASIR increased from 2.7 to 81.0 (males) and from 3.8 to 54.7 (females), slight declines are estimated by 2036 for both genders. Melanoma mortality increased six-fold in New Zealand males between 1950 and 2016; smaller increases were observed in females. We observed three- to four-fold increases in melanoma incidence in US whites, predicted to rise to 56.1 and 36.2 in males and females until 2036. Melanoma mortality also increased among US whites between 1970 and 2017, female melanoma mortality remained stable. Similar trends are shown for KC. CONCLUSIONS: In white populations, incidence of CM and KC significantly increased. CM incidence continues to rise in the short term but is predicted to decline in future.

6.
Medicine (Baltimore) ; 100(22): e25842, 2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-34087827

RESUMEN

ABSTRACT: To investigate the relationship between urinary cotinine and colorectal neoplasm (CRN).The participants in the health screening cohort of the National Cancer Center who underwent screening colonoscopy between June 2007 and December 2009 were included. A total of 8121 subjects who underwent urinary cotinine measurement within 14 days from the index colonoscopy were included. Cotinine positivity was defined as having a urinary cotinine level ≥50 ng/mL. Follow-up colonoscopy data were collected by reviewing the patients' medical records.Patients were classified according to their urinary cotinine level and self-reported smoking status, and the number of patients with cotinine positivity was 1960 (24.1%). There was no significant difference in the cumulative CRN and advanced CRN (ACRN) risks according to the self-reported smoking status. However, cotinine positivity at the time of index colonoscopy was an independent risk factor for CRN (hazard ratio [HR]= 1.23, P = .006) in follow-up colonoscopy. Moreover, in never- and ex-smokers, cotinine positivity was an independent risk factor for CRN (HR = 1.95, P = .019; HR = 2.12, P = .003, respectively) and ACRN (HR = 8.89, P < .001; HR = 5.03, P = .003) during follow-up colonoscopy. The cumulative incidence of CRN and ACRN was higher in the cotinine-positive never- and ex-smokers than in the cotinine-negative never- and ex-smokers (P < .001 and P = .008, respectively).CRN or ACRN is more likely to occur at follow-up colonoscopy in the urinary cotinine-positive never- and ex-smokers than in the urinary cotinine-negative group. Therefore, urinary cotinine measurements may provide useful information on never- or ex-smokers undergoing screening colonoscopy.


Asunto(s)
Neoplasias Colorrectales/epidemiología , Cotinina/orina , Fumadores/estadística & datos numéricos , Fumar Tabaco/epidemiología , Adulto , Factores de Edad , Consumo de Bebidas Alcohólicas/epidemiología , Pesos y Medidas Corporales , Colonoscopía/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales
7.
Medicine (Baltimore) ; 100(22): e26111, 2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-34087858

RESUMEN

ABSTRACT: Gram-negative bacteremia is a major cause of death among hematology inpatients who require heavy-dose chemotherapy and hematopoietic stem cell transplantation. Gram-negative bacillus (GNB) is more likely to be detected when the oral health is poor. However, there is a dearth of studies on the relationship between oral assessment and prevalence of GNB in hematology inpatients.This retrospective study aimed to evaluate the relationship between the original point-rating system for oral health examinations (point-oral exam) and the prevalence of GNB in hematology inpatients at the hematology ward of the Yamanashi University Hospital. GNB was detected by cultivating samples from the sputum and blood of each patient.A total of 129 subjects underwent a medical checkup and point-oral exam. The sputum and blood culture results of 55 patients were included in this study. The total points of patients positive for GNB (n = 25, 45.5%) were significantly higher than those who were negative for GNB (total score: median, 25th, 75th, percentile; 6 [4, 7] vs 2 [1, 4]; P = .00016). Based on the receiver operating characteristic analysis, a cutoff score of 5 proved to be most useful to detect GNB.An oral evaluation with a cutoff value of 5 or higher in the point-oral exam might indicate the need for a more thorough oral management to prevent the development of systemic infections from GNB.


Asunto(s)
Infecciones por Bacterias Gramnegativas/epidemiología , Neoplasias Hematológicas/epidemiología , Salud Bucal/estadística & datos numéricos , Factores de Edad , Anciano , Anciano de 80 o más Años , Cultivo de Sangre , Índice de Masa Corporal , Pesos y Medidas Corporales , Femenino , Humanos , Pacientes Internos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores Sexuales , Esputo/microbiología
8.
Medicine (Baltimore) ; 100(22): e26121, 2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-34087861

RESUMEN

ABSTRACT: This community-based study aimed to elucidate whether there is a gender difference in the effect of metabolic syndrome (MetS) and its individual components on an elevated risk for incident colorectal adenoma.A prospective cohort study was conducted by enrolling 59,767 subjects aged 40 years or older between 2001 and 2009 in Keelung, Taiwan, to test this hypothesis, excluding those with a prior history of colorectal cancer and those with colorectal cancer diagnosed at the first screening. Cox proportional hazards regression models were used to assess the effect of MetS in terms of a dichotomous classification, each individual component and the number of components for males and females.Colorectal adenoma was present in 2.7% (n = 652) of male participants and 1.1% (n = 403) of female participants. The prevalence rate of MetS was 26.7% and 23.3% for males and females, respectively. The effect of MetS on colorectal adenoma was statistically significant and similar for the 2 genders, with an adjusted hazard ratio (aHR) of 1.33 (95% CI: 1.13-1.58) in males and 1.33 (95% CI: 1.06-1.66) in females after adjustment for confounders. However, MetS led to higher risk of advanced colorectal adenoma in men than in women. Regarding the effect of each component of MetS on colorectal adenoma, abnormal waist circumference and hypertriglyceridemia led to an elevated risk of colorectal adenoma in both genders. A rising risk of colorectal adenoma among females was noted in those with a moderately higher level of glycemia (100-125 mg/dL, aHR = 1.44, 95% CI: 1.12-1.85). Hypertriglyceridemia and high blood pressure were associated with an increased risk of advance colorectal adenoma in males.Both male and female subjects with MetS had a higher risk of colorectal adenoma. The contributions from individual components of MetS varied by gender. These findings suggest that the possible risk reduction of colorectal adenoma through metabolic syndrome-based lifestyle modifications may differ between genders.


Asunto(s)
Adenoma/epidemiología , Neoplasias Colorrectales/epidemiología , Síndrome Metabólico/epidemiología , Adulto , Anciano , Pesos y Medidas Corporales , Femenino , Humanos , Hipertensión/epidemiología , Hipertrigliceridemia/epidemiología , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo , Distribución por Sexo , Taiwán/epidemiología
9.
Pan Afr Med J ; 38: 264, 2021.
Artículo en Francés | MEDLINE | ID: mdl-34122691

RESUMEN

Introduction: we conducted the first epidemiological study of patients with breast cancers living in Fianarantsoa. The purpose of this study was to describe the epidemiology and clinical features of these patients in the Department of Oncology Fianarantsoa. Methods: we conducted a retrospective and descriptive study in the Department of Oncology at the University Hospital Center of Tambohobe over a period of 8 years (2011-2018). All patients with breast cancer diagnosed based on cytological and/or histological examination were included. The parameters studied were: age, occupation, a family history of breast cancer, menarche, menopause, parity, use of oral contraceptives, smoking, circumstances leading to detection, breast symptoms, signs of locoregional and distant spread, tumour site and stage of the disease. Results: the study included 62 patients with an average age of 52.83 ± 10.47 years. Housewives accounted for 39% (n = 24) of cases. No patient had an early menarche. Late menopause had occurred in 6.45% (n = 4) of patients and a family history of breast cancer was found in 8.06% (n = 5) of patients. Chewing tobacco was used by 17.74% (n = 11) of patients. Patients reporting breast symptoms accounted for 95.2% (n = 59). Breast cancers had affected the upper outer quadrant in 53.23% (n = 33) of cases. Stage III breast cancer was diagnosed in 55% (n = 34) of cases and stage IV in 32% (n = 20) of cases. Conclusion: in patients diagnosed with cancer at an advanced stage, risk factors for breast cancer were little observed.

10.
Artículo en Inglés | MEDLINE | ID: mdl-34127405

RESUMEN

OBJECTIVE: To assess the epidemiology and outcome at discharge of cancer patients requiring admission to the Intensive Care Unit (ICU). DESIGN: A descriptive observational study was made of data from the ENVIN-HELICS registry, combined with specifically compiled variables. Comparisons were made between patients with and without neoplastic disease, and groups of cancer patients with a poorer outcome were identified. SETTING: Intensive Care Units participating in ENVIN-HELICS 2018, with voluntary participation in the oncological registry. PATIENTS: Subjects admitted during over 24 h and diagnosed with cancer in the last 5 years. PRIMARY ENDPOINTS: The general epidemiological endpoints of the ENVIN-HELICS registry and cancer-related variables. RESULTS: Of the 92 ICUs with full data, a total of 11,796 patients were selected, of which 1786 (15.1%) were cancer patients. The proportion of cancer patients per Unit proved highly variable (1%-48%). In-ICU mortality was higher among the cancer patients than in the non-oncological subjects (12.3% versus 8.9%; p < .001). Elective postoperative (46.7%) or emergency admission (15.3%) predominated in the cancer patients. Patients with medical disease were in more serious condition, with longer stay and greater mortality (27.5%). The patients admitted to the ICU due to nonsurgical disease related to cancer exhibited the highest mortality rate (31.4%). CONCLUSIONS: Great variability was recorded in the percentage of cancer patients in the different ICUs. A total of 46.7% of the patients were admitted after undergoing scheduled surgery. The highest mortality rate corresponded to patients with medical disease (27.5%), and to those admitted due to cancer-related complications (31.4%).

11.
Cancer Rep (Hoboken) ; : e1448, 2021 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-34129289

RESUMEN

BACKGROUND: Cancer incidence and cancer registries are essential for local epidemiological information. In Libya, scarce evidence exists with regard to incidence rates and distribution. AIM: To estimate cancer incidence in Libya and draw trends of cancer type distribution compared to regional and worldwide data. Such incidence data are needed to inform strategic decisions on cancer facilities, training, and research in the given geographical area of Misurata, the major city in the middle region and third largest in Libya. METHODS: This is an observational, multi-centre, city-wide study to account for all cancer cases. All radiology (computed tomography and magnetic resonance imaging) and pathology reports were examined across all public and private hospitals in and around Misurata. RESULTS: Four hundred and thirty cancer cases were identified to have been diagnosed during 12 months (July 2019-June 2020), yielding a cancer incidence of 71.7 per 100 000 population. Breast cancer (84, 19.5%), colorectal cancer (83, 19.3%), lung cancer (33, 7.7%), and prostate cancer (21, 4.9%) had the highest prevalence. CONCLUSION: Cancer incidence established in this study stands at 71.1, much lower than the worldwide reported incidence of 201.0. Several limitations lead to missing cancer cases from the survey period, mostly related to poor documentation, non-research friendly environment, and disorganised healthcare structure. Nevertheless, distribution by type represents a true contrast to the world cancer report. Finally, a national or regional inclusive cancer registry is essential to the flow of information that supports strategic planning and decision-making in developing cancer care in the country.

12.
Arch. pediatr. Urug ; 92(1): e202, jun. 2021. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1248841

RESUMEN

Resumen: Objetivo: describir la incidencia y supervivencia en niños y adolescentes con cáncer en Uruguay y analizar su evolución mediante la comparación de los períodos 1992-1994 y 2008-2012. Material y método: estudio observacional y descriptivo. Se incluyeron todos los pacientes entre 0 y 14 años diagnosticados de cáncer en todo el territorio uruguayo en el período 2008-2012. Fuente de datos: Registros del Servicio de Hematología y Oncología Pediátrica del Centro Hospitalario Pereira Rossell. Los diagnósticos fueron agrupados de acuerdo con la International Classification of Childhood Cancer, Third Edition. La información del tamaño de la población y de su distribución según la edad fue obtenida de registros de censos nacionales y de organismos internacionales. Se determinó incidencia y supervivencia. Se estableció el seguimiento de los sobrevivientes por un mínimo de seis años para asegurar una estimación precisa de la sobrevida. Resultados: se incluyeron 504 pacientes entre 0 y 14 años. La tasa de incidencia para todos los cánceres fue de 134,6 casos por millón por año, 147,6 y 120,7 para varones y niñas, respectivamente. La mayor incidencia fue observada para leucemias (grupo I) (40,6), tumores del sistema nervioso central (grupo III) (28,0) y linfomas (grupo II) (17,6). La tasa de sobrevida a cinco años mejoró significativamente para todos los cánceres de 54,7% (1992-1994) a 70,6% (2008-2012) (varones 49,2% a 69,6%; niñas 58,9% a 72,3%). Conclusiones: este estudio aporta información confiable de la incidencia y sobrevida del cáncer en Uruguay en pacientes menores de 15 años. Los resultados hallados demuestran cambios en la distribución de la población de Uruguay, una tasa de incidencia de cáncer estable en el grupo etario analizado y un progreso significativo en la supervivencia comparado con el estudio realizado hace 20 años, pero confirman que Uruguay tiene desafíos por delante para alcanzar tasas de cura del cáncer similares a los países de Europa Occidental y América del Norte.


Summary: Objectives: describe the incidence and survival of children and adolescents with cancer in Uruguay and analyze their evolution by comparing the periods 1992-1994 and 2008-2012. Materials and methods: descriptive and observational study. We included all patients between 0 and 14 years of age diagnosed with cancer in Uruguay during 2008-2012. Data source: Pereira Rossell Children's Hospital Records of the Pediatric Hematology and Oncology Department. The diagnoses were grouped according to the Third Edition of the Childhood Cancer's International Classification. Data regarding population size and distribution by age was obtained from national census records and from international organizations. We determined incidence and survival. Follow-up of survivors was established for a minimum of 6 years to ensure an accurate estimate of survival. Results: we included five hundred and four (504) patients between 0 and 14 years of age. The incidence rate for all cancers was 134.6 cases per million per year, 147.6 and 120.7 for boys and girls, respectively. The highest incidence was leukemia (group I) (40.6), tumors of the central nervous system (group III) (28.0) and lymphomas (group II) (17.6). The 5-year survival rate improved significantly for all cancers from 54.7% (1992-1994) to 70.6% (2008-2012) (males 49.2% to 69.6%; girls 58.9% to 72.3%). Conclusions: this study provides reliable information on the incidence and survival of cancer in Uruguay in patients under 15 years of age. The results found demonstrate changes in the distribution of the population of Uruguay, a stable cancer incidence rate in the age group analyzed and significant progress in survival compared to the study carried out 20 years ago, but confirm that Uruguay has challenges ahead in order to achieve cancer cure rates similar to those of Western European and North American countries.


Resumo: Objetivos: descrever a incidência e sobrevida em crianças e adolescentes com câncer no Uruguai e analisar sua evolução comparando os períodos 1992-1994 e 2008-2012. Materiais e métodos: estudo observacional e descritivo. Incluíram-se todos os pacientes de 0 a 14 anos de idade com diagnóstico de câncer em Uruguai no período 2008-2012. Fonte de dados: Prontuários do Serviço de Hematologia e Oncologia Pediátrica do Centro Hospitalar Pereira Rossell. Os diagnósticos foram agrupados de acordo com a Classificação Internacional de Câncer Infantil, Terceira Edição. As informações sobre o tamanho da população e sua distribuição por faixa etária foram obtidas nos registros censitários nacionais e em organismos internacionais. Determinaram-se a incidência e sobrevivência. Os sobreviventes foram acompanhados por um período mínimo de 6 anos para garantir uma estimativa precisa de sobrevida. Resultados: incluíram-se 504 pacientes entre 0 e 14 anos de idade. A taxa de incidência para todos os cânceres foi de 134,6 casos por milhão por ano, 147,6 e 120,7 para meninos e meninas, respectivamente. A maior incidência observou-se para leucemias (grupo I) (40,6), tumores do sistema nervoso central (grupo III) (28,0) e linfomas (grupo II) (17,6). A taxa de sobrevida em 5 anos melhorou significativamente para todos os cânceres de 54,7% (1992-1994) para 70,6% (2008-2012) (homens 49,2% a 69,6%; meninas 58,9% a 72,3%). Conclusões: este estudo fornece informação confiável sobre a incidência e sobrevida do câncer no Uruguai em pacientes com menos de 15 anos de idade. Os resultados encontrados mostram mudanças na distribuição da população uruguaia, taxa de incidência de câncer estável na faixa etária analisada e avanço significativo na sobrevida em relação ao estudo realizado há 20 anos, mas confirmam que o Uruguai tem desafios pela frente para atingir taxas de cura do câncer semelhantes aos países da Europa Ocidental e da América do Norte.

14.
Trop Doct ; : 494755211020573, 2021 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-34080910

RESUMEN

Barbados is a Caribbean island with a high incidence of colorectal cancer. This study collected epidemiologic data from Barbadian patients with colorectal cancer. There was an opportunity for targeted screening in patients actively enrolled in clinics for management of chronic diseases, accounting for 72% of cases. We also identified areas of high incidence where resources should be directed in a screening programme.

15.
Breast Dis ; 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-34120895

RESUMEN

The survival after the diagnosis of inflammatory breast cancer (IBC) has been steadily improving for the past few decades. This has been due to advances in the knowledge of IBC in a number of fields, including epidemiology, molecular biology, and medical management. In this review we summarize some of the most important recent advances in these fields and suggest possible opportunities for continued improvement.

16.
J Bone Miner Metab ; 2021 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-34125296

RESUMEN

INTRODUCTION: Glucocorticoid-induced osteoporosis (GIOP) is associated with a high fracture risk. Practice guidelines by the Japanese Society for Bone and Mineral Research in 2014 recommend bone densitometry and appropriate treatment to reduce this risk. The study objectives were to describe characteristics of GIOP patients in Japan and to evaluate their management in a subgroup of patients without comorbid cancer. MATERIALS AND METHODS: This retrospective cohort study was performed using the Medical Data Vision (MDV) database from Japan. Adult patients initiating oral glucocorticoid treatment with a total GIOP risk score ≥ 3, based on the 2014 practice guideline, identified between 2009 and 2019 were eligible. A subgroup of patients without any cancer diagnosis was also identified. Data were extracted on demographics, concurrent medical conditions, use of bone densitometry, and osteoporosis treatment. RESULTS: 25,569 patients were eligible, of whom 12,227 had a confirmed cancer diagnosis. Mean age was 68.5 years and 12,356 patients (48.3%) were women. Concurrent medical conditions of interest were documented in 14,887 patients, most frequently rheumatoid arthritis (n = 4185) and asthma (n = 3085). Yearly bone densitometry was performed in 6.5% (n = 865) of the cancer-free subgroup; 51.8% (n = 6905) were prescribed an osteoporosis treatment, most frequently bisphosphonates (n = 5132; 74.3%). Between 2011 and 2018, rates of densitometry were stable, whereas prescription rates increased from 40.0 to 51.8%. CONCLUSION: In spite of publication of guidelines for GIOP management, there is an important treatment gap in their application in everyday practice. For this reason, public health measures to increase physician awareness of GIOP are needed.

17.
PLoS One ; 16(6): e0251761, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34077442

RESUMEN

BACKGROUND: Small-cell lung cancer (SCLC) is an aggressive disease with high metastatic potential and poor prognosis. Due to its low prevalence, epidemiological and clinical information of SCLC patients retrieved from lung cancer registries is scarce. PATIENTS AND METHODS: This was an observational multicenter study that enrolled patients with lung cancer and thoracic tumors, recruited from August 2016 to January 2020 at 50 Spanish hospitals. Demographic and clinical data, treatment patterns and survival of SCLC patients included in the Thoracic Tumor Registry (TTR) were analyzed. RESULTS: With a total of 956 cases, the age of 64.7 ± 9.1 years, 78.6% were men, 60.6% smokers, and ECOG PS 0, 1 or ≥ 2 in 23.1%, 53.0% and 23.8% of cases, respectively. Twenty percent of patients had brain metastases at the diagnosis. First-line chemotherapy (CT), mainly carboplatin or cisplatin plus etoposide was administered to >90% of patients. In total, 36.0% and 13.8% of patients received a second and third line of CT, respectively. Median overall survival was 9.5 months (95% CI 8.8-10.2 months), with an estimated rate of 70.3% (95% CI 67.2-73.4%), 38.9% (95% CI 35.4-42.4%), and 14.8% (95% CI 11.8-17.8%) at 6, 12 and 24 months respectively. Median progression-free survival was 6.3 months. Higher mortality and progression rates were significantly associated with male sex, older age, smoking habit, and ECOG PS 1-2. Long-term survival (> 2 years) was confirmed in 6.6% of patients, showing a positive correlation with better ECOG PS, poor smoking and absence of certain metastases at diagnosis. CONCLUSION: This study provides an updated overview of the clinical situation and treatment landscape of ES-SCLC in Spain. Our results might assist oncologists to improve current clinical practice towards a better prognosis for these patients.

18.
J Cancer Educ ; 2021 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-34076841

RESUMEN

This manuscript provides a brief overview of the global aspects of the Cancer Epidemiology Education in Special Populations (CEESP) Program. The overview illustrates program history, aims, progress, evaluation, and dissemination. This manuscript sets the stage for the CEESP manuscripts included in this supplement that illustrate in the program infrastructure, mentoring, the student experiences, and unique features of students for achieving success. In this manuscript, we briefly outline some of the dissemination examples that resulted from utilizing the CEESP infrastructure, as outlined in some of the articles reporting on global research training sites from Egypt, Morocco, Oman, and Tanzania.

19.
Eur J Cancer Prev ; 2021 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-34115692

RESUMEN

Non-Hispanic Blacks were shown to have an earlier stage of renal cell carcinoma (RCC) at diagnosis compared to non-Hispanic Whites. It is less clear whether disparities in RCC staging occurs for other minority races/ethnicities. We aimed to assess the association between racial/ethnic minorities and stage at diagnosis of RCC, and test for potential effect modification by histological subtype. Sourced from the Surveillance, Epidemiology and End Results (SEER) database, patients ≥20 years diagnosed with RCC from 2007 to 2015 were included (n = 37 493). Logistic regression analyses were performed to assess the independent association between race/ethnicity [non-Hispanic White, non-Hispanic Black, non-Hispanic Asian Pacific Islander, non-Hispanic American Indian/Alaskan Native (AI/AN) and Hispanic] and advanced RCC stage at diagnosis (i.e. regional spread or distant metastasis). Interaction terms were tested and stratified regression was performed accordingly. Twenty-eight percent of patients had advanced RCC stage at diagnosis. After adjusting for age, gender, year of diagnosis, histological subtype and insurance status, compared to non-Hispanic Whites, non-Hispanic Blacks had lower odds of advanced stage at diagnosis [odds ratio (OR) = 0.79; 95% confidence interval (CI) = 0.72-0.87 for clear cell; OR = 0.48; CI = 0.30-0.78 for chromophobe and OR = 0.26; CI = 0.10-0.35 for other subtypes]. Higher odds of advanced stage at diagnosis were found for non-Hispanic AI/AN in clear cell (OR = 1.27; CI = 1.04-1.55) and for Hispanics in papillary subtypes (OR = 1.58; CI = 1.07-2.33). Racial disparities in the RCC stage at diagnosis varied according to histological subtype. Further investigation on the racial disparities reported is warranted to optimize detection and ultimately improve the prognosis of patients with RCC.

20.
Curr Oncol ; 28(3): 1867-1878, 2021 05 13.
Artículo en Inglés | MEDLINE | ID: mdl-34068441

RESUMEN

Cancer causes substantial emotional and psychosocial distress, which may be exacerbated by delays in treatment. The COVID-19 pandemic has resulted in increased wait times for many patients with cancer. In this study, the psychosocial distress associated with waiting for cancer surgery during the pandemic was investigated. This cross-sectional, convergent mixed-methods study included patients with lower priority disease during the first wave of COVID-19 at an academic, tertiary care hospital in eastern Canada. Participants underwent semi-structured interviews and completed two questionnaires: Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS). Qualitative analysis was completed through a thematic analysis approach, with integration achieved through triangulation. Fourteen participants were recruited, with cancer sites including thyroid, kidney, breast, prostate, and a gynecological disorder. Increased anxiety symptoms were found in 36% of patients and depressive symptoms in 14%. Similarly, 64% of patients experienced moderate or high stress. Six key themes were identified, including uncertainty, life changes, coping strategies, communication, experience, and health services. Participants discussed substantial distress associated with lifestyle changes and uncertain treatment timelines. Participants identified quality communication with their healthcare team and individualized coping strategies as being partially protective against such symptoms. Delays in surgery for patients with cancer during the COVID-19 pandemic resulted in extensive psychosocial distress. Patients may be able to mitigate these symptoms partially through various coping mechanisms and improved communication with their healthcare teams.


Asunto(s)
Ansiedad/epidemiología , COVID-19/prevención & control , Depresión/epidemiología , Neoplasias/cirugía , Tiempo de Tratamiento , Adaptación Psicológica , Adulto , Anciano , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/psicología , COVID-19/epidemiología , COVID-19/transmisión , Control de Enfermedades Transmisibles/normas , Estudios Transversales , Depresión/diagnóstico , Depresión/etiología , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/psicología , Nueva Escocia/epidemiología , Pandemias/prevención & control , Distrés Psicológico , Psicometría/estadística & datos numéricos , Investigación Cualitativa , Autoinforme/estadística & datos numéricos , Triaje/normas , Incertidumbre
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