Increasing Gap Between Thyroid Cancer Incidence and Mortality in Urban Shanghai, China: An Analysis Spanning 43 Years.

OBJECTIVE: To examine the secular trends of thyroid cancer incidence and mortality and to estimate the proportion of thyroid cancer cases potentially attributable to overdiagnosis. METHODS: Data on thyroid cancer cases from 1973 to 2015 were obtained from the Shanghai Cancer Registry. The average annual percent change (AAPC) was evaluated using the joinpoint regression analysis. The age, period, and birth cohort effects were assessed using an age-period-cohort model. The overdiagnosis of thyroid cancer cases was estimated based on the difference between observed and expected incidences using the rates of Nordic countries as reference. RESULTS: From 1973 to 2015, the number of thyroid cancer cases was 23 117, and 75% of the patients were women. The age-standardized rates were seven- to eightfold higher from 2013 to 2015 than from 1973 to 1977. Compared with relatively stable mortality, thyroid cancer incidence was dramatically increased from 2002 to 2015 in both sexes, with significant trends (men: AAPC = 21.84%, 95% CI: 18.77%-24.98%, P < .001; women: AAPC = 18.55%, 95% CI: 16.49%-20.64%, P < .001). The proportion of overdiagnosis has gradually increased over time, rising from 68% between 2003 and 2007 to more than 90% between 2013 and 2015. This increasing trend appeared to be similar between men and women. CONCLUSION: An increasing gap between thyroid cancer incidence and mortality was observed in Shanghai, and overdiagnosis has contributed substantially to the rise of incidence, which calls for an urgent update on the practice of thyroid examination.

Transcriptome Based Estrogen Related Genes Biomarkers for Diagnosis and Prognosis in Non-small Cell Lung Cancer.

BACKGROUND: Lung cancer is the tumor with the highest morbidity and mortality, and has become a global public health problem. The incidence of lung cancer in men has declined in some countries and regions, while the incidence of lung cancer in women has been slowly increasing. Therefore, the aim is to explore whether estrogen-related genes are associated with the incidence and prognosis of lung cancer. METHODS: We obtained all estrogen receptor genes and estrogen signaling pathway genes in The Cancer Genome Atlas (TCGA), and then compared the expression of each gene in tumor tissues and adjacent normal tissues for lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) separately. Survival analysis was performed of the differentially expressed genes in LUAD and LUSC patients separately. The diagnostic and prognostic values of the candidate genes were validated in the Gene Expression Omnibus (GEO) datasets. RESULTS: We found 5 estrogen receptor genes and 66 estrogen pathway genes in TCGA. A total of 50 genes were differently expressed between tumor tissues and adjacent normal tissues and 6 of the 50 genes were related to the prognosis of LUAD in TCGA. 56 genes were differently expressed between tumor tissues and adjacent normal tissues and none of the 56 genes was related to the prognosis of LUSC in TCGA. GEO datasets validated that the 6 genes (SHC1, FKBP4, NRAS, PRKCD, KRAS, ADCY9) had different expression between tumor tissues and adjacent normal tissues in LUAD, and 3 genes (FKBP4, KRAS, ADCY9) were related to the prognosis of LUAD. CONCLUSIONS: The expressions of FKBP4 and ADCY9 are related to the pathogenesis and prognosis of LUAD. FKBP4 and ADCY9 may serve as biomarkers in LUAD screening and prognosis prediction in clinical settings.

Values of liquid biopsy in early detection of cancer: results from meta-analysis.

BACKGROUND: There is tremendous interest in the development of liquid biopsy techniques, but the potential role of liquid biopsy for the early detection of cancer has not yet been elucidated. We aim to explore the performance of liquid biopsy in the early diagnosis of cancer. METHODS: A systematic review was conducted of liquid biopsy in cancer early detection. Meta-regression was carried out to explore the source of heterogeneity and publication bias was also evaluated. RESULTS: Overall, there were six types of biomarkers and 17 studies focusing on liquid biopsy in the early detection of cancer, 7 studies in ctDNA, 5 studies in cfDNA, 2 studies in CTC, and the other three studies used circulating nucleosome, microRNA, and multiple biomarkers, respectively. Pooled sensitivity and specificity of liquid biopsy in cancer early detection was 0.76 (95%CI:0.67-0.83) and 0.92 (95%CI:0.86-0.96) and the area under the SROC curve was 0.91 (95%CI:0.88-0.93). CONCLUSIONS: The current evidence shows that liquid biopsy has relatively low sensitivity and high specificity in cancer early detection. Among all these biomarkers, cfDNA may have potentially promising value in cancer early detection, thereby supporting further study of cancer early detection. STUDY REGISTRATION: The study is registered at PROSPERO (Identifier number: CRD42020137205).

Effects of atmospheric particulate matter pollution on sleep disorders and sleep duration: a cross-sectional study in the UK biobank.

BACKGROUND: Sleep disorder prevalence exhibited a six-fold relative increase from 2000 to 2010 in the United States. Sleep problems could increase the risk of stroke, cardiovascular disease, diabetes and cancer. Objective short sleep duration is associated with increased mortality. Obesity, smoking and sex differences could influence sleep disorders and sleep duration. The health effects of atmospheric particulate matter (PM) pollution are of great concern. However, a large general population-based study with abundant demographic and lifestyle information is needed to confirm the effect of PM pollution on sleep disorders and sleep duration. METHODS: Information on PM air pollution, demographics and other related factors was obtained from the UK Biobank. Subjects' characteristics were described as the means and 95% confidence intervals (95% CIs) for continuous variables and counts (percentages) for categorical variables. In the case-control study of sleep disorders, univariate analysis, single-pollutant models and a four-pollutant model with logistic regression were performed to estimate the odds ratio (OR) of the risk factors. For sleep duration, univariate analysis, single-pollutant models and a four-pollutant model with linear regressions were carried out to assess the effect of the factors. Sensitivity analysis was performed by data imputation and study population change. RESULTS: There were 5976 cases and 97,160 controls included in the case-control study of sleep disorders. For sleep duration analysis, most of the participants had environmental PM data, and 457,358 participants were selected. The single-pollutant models showed that the OR of PM2.5 for sleep disorders was 2.39 (95% CI: 1.64-3.48) for every 10 µg/m3 increase. PM2.5 and PM10 reduced sleep duration by 0.14 (95% CI: 0.10-0.18) and 0.12 (95% CI: 0.10-0.14) hours for every 10 µg/m3 increase, respectively. Four-pollutant models showed that the OR of PM2.5 for sleep disorders was 4.42 (95% CI: 2.36-8.26) for every 10 µg/m3 increase. PM10 appeared to reduce sleep duration by 0.09 (95% CI: 0.06-0.12) hours for every 10 µg/m3 increase. The main results showed good robustness after sensitivity analysis. CONCLUSIONS: PM2.5 was a risk factor for sleep disorders. PM2.5 and PM10 reduced sleep duration. A reduction in particulate matter exposure may decrease the risk of sleep disorders and improve sleep duration.

Distinctive lung cancer incidence trends among men and women attributable to the period effect in Shanghai: An analysis spanning 42 years.

BACKGROUND: Many previous studies reported secular trend of lung cancer incidence and mortality, but little is known about the possible reasons for these trends. METHODS: Data were obtained from Shanghai Cancer Registry. Age-standardized rates were calculated and average annual percent changes (AAPCs) were evaluated by Joinpoint regression. Age, period, and birth cohort effects were assessed by age-period-cohort models. RESULTS: From 1973 to 2010, compared with long-time slowly increasing trend in women, male lung cancer incidence had significantly decreased between 2001 and 2009. After that lung cancer incidence rising sharply in women (AAPC = 14.13%, 95%CI: 2.68%-26.86%, P = .016) and similar rising trends without statistical significance in men (AAPC = 2.96, 95%CI: -2.47%-8.69%, P = .281) between 2010 and 2014. Age-period cohort model showed the different patterns of period effects for lung cancer incidence between men and women. The period effects for lung cancer incidence showed rising effect for women, whereas there was decline effect for lung cancer incidence for men. On the other hand, the model showed a significant period effect in both genders with a similar fashion in mortality, yielding steady falling trends during the entire study period. CONCLUSIONS: The distinctive patterns of lung cancer incidence between men and women may be attributable to significant period effects, which reflected the changes in public health policies or diagnostic practices and highlighted the urgent of continued monitoring of gender-specific risk factors for lung cancer incidence.