Global burden, risk factors, and trends of non-Hodgkin lymphoma: A worldwide analysis of cancer registries.

BACKGROUND: Non-Hodgkin lymphoma (NHL) accounts for 90% of all malignant lymphomas. This study aimed to evaluate the global incidence, mortality, associated risk factors, and temporal trends of NHL by sex, age, and country. METHODS: Data from 185 countries globally were used for analysis. NHL incidence and mortality were collected via the GLOBOCAN (2020), CI5 series I-X, WHO mortality database, the Nordic Cancer Registries, and the SEER Program. The WHO Global Health Observatory provided country-level, age-standardized prevalence of lifestyle and metabolic risk factors. Trends were examined and reported based on average annual percentage change (AAPC) calculated using Joinpoint regression analysis. Incidence and AAPC are based on data for the last 10 years across countries. RESULTS: Globally, age-standardized incidence and mortality rates for NHL were recorded at 5.8 and 2.6 per 100,000 individuals, respectively. At country-level, NHL incidence was significantly associated with various factors, including HDI (Human Development Index), GDP per capita, prevalence of tobacco and alcohol consumption, sedentary lifestyle, obesity, hypertension, diabetes and hypercholesterolaemia. Rising trend in NHL incidence was observed, with the highest increase recorded in Estonia (AAPCmale = 4.15, AAPCfemale = 5.14), Belarus (AAPCfemale = 5.13), and Lithuania (AAPCfemale = 4.68). While overall NHL mortality has been decreasing, certain populations experienced increased mortality over the decade. In Thailand, AAPC for mortality was 31.28% for males and 30.26% for females. Estonia saw an AAPC of 6.46% for males, while Slovakia experienced an AAPC of 4.24% for females. Colombia's AAPC was 1.29% for males and 1.51% for females. CONCLUSIONS: This study indicates a rising trend of NHL incidence over the past decade- particularly in developed countries, older males, and younger populations. Further research should investigate deeper insights into specific etiology and prognosis of NHL across subtypes, and potential contributors towards these epidemiologic trends.

Disease burden, risk factors, and temporal trends of eye cancer: A global analysis of cancer registries.

BACKGROUND: This study aims to investigate the global disease burden, risk factors, and temporal trends of eye cancer by sex and age group. METHODS: Databases including Cancer Incidence in Five Continents volumes I-XI, the Nordic Cancer Registries, the Surveillance, Epidemiology, and End Results Program and the WHO IARC mortality database were accessed to extract incidence and mortality data. Joinpoint regression analyses were conducted to evaluate the Average Annual Percentage Change of the incidence and mortality. RESULTS: The age-standardised rates of eye cancer incidence and mortality were 0.49 and 0.08 globally in 2020. Higher incidence rates were observed in Sub-Saharan Africa (ASR = 4.06), Western Europe (ASR = 0.89), and Northern Europe (ASR = 0.84), but higher mortality was observed only in Sub-Saharan Africa (ASR = 1.59). Lower HDI, higher prevalence of UV exposure and lower prevalence of several lifestyle habits and metabolic syndromes were associated with higher incidence and mortality. There was an overall stable incidence trend and a decreasing mortality trend. Notably, all countries reporting decreasing trend in mortality were in the Asian or European region. CONCLUSIONS: Although higher incidence was observed in both African and European regions, only the Sub-Saharan Africa region reported high mortality, indicating inequity in the access of healthcare and treatment resource. Higher prevalence of UV exposure was associated with both higher incidence and mortality. Education should be provided to increase the awareness of eye protection. An overall declining mortality trend was found, but it was limited to only Asian and European countries.

Updated disease distributions, risk factors, and trends of laryngeal cancer: a global analysis of cancer registries.

BACKGROUND: Though the laryngeal cancer only has 1% of the total cancer cases and related deaths, it is a type of head and neck cancers with the highest prevalence. This study aims to investigate the epidemiological trend of laryngeal cancer with updated data on the global distribution of the disease burden. MATERIALS AND METHODS: The incidence and mortality rate of laryngeal cancer was extracted from GLOBOCAN (2020), Cancer Incidence in Five Continents series I-X, WHO mortality database , the Nordic Cancer Registries , and the Surveillance, Epidemiology, and End Results Program. The Global Health data exchanges for the prevalence of its associated risk factors. A Joinpoint regression analysis was used to calculate Average Annual Percentage Change (AAPC). RESULTS: The age-standardised rate (ASR) of laryngeal cancer incidence and mortality were 2.0 and 1.0 per 100 000 worldwide. The Caribbean (ASR=4.0) and Central and Eastern Europe (ASR=3.6) had the highest incidence and mortality rate. Incidence and risk factors associated with laryngeal cancer included tobacco usage, alcohol consumption, poor diet, obesity, diabetes, hypertension, and lipid disorders. There was an overall decreasing trend in incidence, especially for males, but an increasing incidence was observed in female populations and younger subjects. CONCLUSIONS: As overall global trends of laryngeal cancer have been decreasing, especially for the male population, this could possibly be attributed to reduced tobacco use and alcohol consumption. Decrease in mortality may be due to improved diagnostic methods and accessibility to treatment, yet disparity in trend remains potentially because of differences in the level of access to surgical care. Disparities in temporal trends across countries may require further research and exploration to determine other underlying factors influencing this.

Changes in anxiety and depression during the COVID-19 pandemic in the European population: A meta-analysis of changes and associations with restriction policies.

BACKGROUND: Early studies of common mental disorders (CMDs) during the COVID-19 pandemic mainly report increases; however, more recent findings have been mixed. Also, studies assessing the effects of restriction measures on CMDs show varied results. The aim of this meta-analysis was to assess changes in levels of CMDs from pre-/early to during the pandemic and the effects of restriction policies in the European population. METHODS: We searched for studies assessing both pre-pandemic and peri-pandemic self-reported emotional distress and symptoms of depression or anxiety among nationally/regionally representative samples in Europe and collected microdata from those studies. Estimates of corona containment index were related to changes in CMDs using random-effects meta-regression. RESULTS: Our search strategy resulted in findings from 15 datasets drawn from 8 European countries being included in the meta-analysis. There was no evidence of change in the prevalence of emotional distress, anxiety, or depression from before to during the pandemic; but from early pandemic periods to later periods, there were significant decreases in emotional distress and anxiety. Increased school restrictions and social distancing were associated with small increases in self-reported emotional distress. CONCLUSIONS: Despite initial concerns of increased emotional distress and mental illness due to the COVID-19 pandemic, the results from this meta-analysis indicate that there was a decrease in emotional distress and no change in anxiety or depression in the general population in Europe. Overall, our findings support the importance of strong governance when implementing periodic and robust restriction measures to combat the spread of COVID-19.

Global incidence, risk factors and trends of vulvar cancer: A country-based analysis of cancer registries.

Vulvar cancer is an uncommon malignancy. Vulvar cancer alarmed the public health problem in terms of the cost of diagnostic and medical treatments and psychical health of females. Our study aims to provide a thorough analysis of the global disease burden, related risk factors and temporal incidence trends of vulvar cancer in population subgroups. Data from Global Cancer Observatory and the Cancer Incidence in Five Continents Plus were used for the vulvar cancer incidence. Age-standardized rates (ASR) were used to depict the incidence of vulvar cancer. The 10-year trend of incidence was assessed using joinpoint regression with average annual percentage change and 95% confidence intervals in various age groups, while its correlations with risk factors were investigated using linear regression. Higher ASR were found in Western Europe (2.4), Northern America (1.9), Northern Europe (1.9), Australia and New Zealand (1.8) and Eastern Africa (1.4). The associated risk factors of higher vulvar cancer incidence were gross domestic product per capita, Human Development Index, higher prevalence of smoking, alcohol drinking, unsafe sex and human immunodeficiency virus infection. The overall trend of vulvar cancer incidence was increasing. An increasing trend was found in older females while a mixed trend was observed in younger females. The disease burden of vulvar cancer follows a bimodal pattern according to its two histologic pathways, affecting women in both developed and developing regions. Smoking cessation, sex education and human papillomavirus vaccination programs should be promoted among the general population. Subsequent studies can be done to explore the reasons behind the increasing trend of vulvar cancer.

Disease burden, risk factors, and trends of lip, oral cavity, pharyngeal cancers: A global analysis.

BACKGROUND: Lip, oral and pharyngeal cancers make up a small percentage of total cancer cases worldwide and have reported lower rates of cancer-related deaths globally in 2020, but their 5-year survival rate in either early or advanced stages is different. The study evaluated the global incidence, mortality, risk factors, and temporal trends by age, gender, and geographical locations of lip, oral cavity, and pharyngeal cancer. METHODS: Incidence and mortality rates were extracted from Cancer Incidence in Five Continents (CI5) volumes I-XI, the Nordic Cancer Registries (NORDCAN), the Surveillance, Epidemiology, and End Results (SEER) Program, and the WHO IARC mortality database. Joinpoint regression was used to calculate the Average Annual Percentage Change to examine trends. RESULTS: The highest incidence rates were found in Melanesia and South-Central Asia and mortality rates were 8.2 and 7.5. Risk factors associated with incidence and mortality included HDI, tobacco use, alcohol consumption, poor diet, and chronic health conditions such as hypertension. Increasing trends of incidence and mortality were observed in females from Malta; males aged 50 and above from the United Kingdom, and females aged 50 and above from Slovakia reporting the largest increase. CONCLUSIONS: Although global incidence and mortality trends reported an overall decrease, significant increases were found for older age groups and female subjects. Incidence increase may be due to the growing prevalence of lifestyle, metabolic risk factors, and HPV infections, especially in developed countries.

Incidence, Risk Factors, and Temporal Trends of Small Intestinal Cancer: A Global Analysis of Cancer Registries.

BACKGROUND & AIMS: Small intestinal cancer is a rare cancer, with limited studies exploring its epidemiology. To our knowledge, this study is the first effort to comprehensively analyze the incidence, risk factors, and trends for small intestinal cancer by sex, age, and country. METHODS: Global Cancer Observatory, Cancer Incidence in Five Continents Plus, and Global Burden of Disease were accessed to estimate the age-standardized rates of small intestinal cancer incidence (International Classification of Diseases, 10th Revision, Clinical Modification: C17) and prevalence of lifestyle risk factors, metabolic risk factors, and inflammatory bowel disease (IBD). Risk factor associations were assessed by linear and logistic regressions. Average annual percent change was calculated using joinpoint regression. RESULTS: A total of 64,477 small intestinal cancer cases (age-standardized rate, 0.60 per 100,000) were estimated globally in 2020, with a higher disease burden found in North America (1.4). Higher small intestinal cancer incidence was associated with higher human development index; gross domestic product; and prevalence of smoking, alcohol drinking, physical inactivity, obesity, diabetes, lipid disorder, and IBD (ß = 0.008-0.198; odds ratios, 1.07-10.01). There was an overall increasing trend of small intestinal cancer incidence (average annual percent change, 2.20-21.67), and the increasing trend was comparable among the 2 sexes but more evident in the older population aged 50-74 years than in the younger population aged 15-49 years. CONCLUSION: There was a substantial geographic disparity in the burden of small intestinal cancer, with higher incidence observed in countries with higher human development index; gross domestic product; and prevalence of unhealthy lifestyle habits, metabolic disorders, and IBD. There was an overall increasing trend in small intestinal cancer incidence, calling for the development of preventive strategies.

Global Incidence, Mortality, Risk Factors and Trends of Melanoma: A Systematic Analysis of Registries.

BACKGROUND: Melanoma of the skin is the most dangerous skin cancer in the world, though the numbers of reported new cases and melanoma-related deaths are low. OBJECTIVE: This study evaluated the global incidence, mortality, risk factors and temporal trends by age, sex and locations of melanoma skin cancer. PATIENTS AND METHODS: Cancer Incidence in Five Continents (CI5) volumes I-XI; the Nordic Cancer Registries (NORDCAN); the Surveillance, Epidemiology and End Results (SEER) Program; and the World Health Organization (WHO) International Agency for Research on Cancer (IARC) mortality database were accessed for worldwide incidence and mortality rates. Average Annual Percentage Change (AAPC) was calculated using a Joinpoint regression to examine trends. RESULTS: Age-standardized rates of cancer incidence and mortality were 3.4 and 0.55 per 100,000 worldwide in 2020. Australia and New Zealand reported the highest incidence and mortality rates. Associated risk factors included higher prevalence of smoking, alcohol consumption, unhealthy diet, obesity and metabolic diseases. Increasing incidence trends were observed mostly in European countries, whilst mortality displayed an overall decreasing trend. For both sexes in the age group 50 years and above, a significant increase in incidence trend was observed. CONCLUSIONS: Although mortality rates and trends were found to decrease, global incidence has increased, especially in older age groups and males. Whilst incidence increase may be attributed to improved healthcare infrastructure and cancer detection methods, the growing prevalence of lifestyle and metabolic risk factors in developed countries should not be discounted. Future research should explore underlying variables behind epidemiological trends.

Global incidence and mortality trends of corpus uteri cancer and associations with gross domestic product, human development index, lifestyle, and metabolic risk factors.

OBJECTIVE: To evaluate the worldwide distribution, risk factors, and temporal trends of corpus uteri cancer for different countries and age groups. METHOD: Data relating to corpus uteri cancer in 2020 were retrieved from the Global Cancer Observatory database. Data from Cancer Incidence in Five Continents and the WHO mortality database were used for trend analysis. Age-standardized rates (ASR, per 100 000 persons) were calculated for incidence and mortality. Joinpoint regression analysis was used to estimate the 10-year annual average percent change (AAPC). RESULTS: A total of 417 367 new cases and 97 370 new deaths of corpus uteri cancer were reported globally in 2020. The highest incidence was observed in high-income countries. Higher ASR of mortality of corpus uteri cancer was associated with a higher gross domestic product per capita, higher Human Development Index, and higher prevalence of smoking, alcohol drinking, physical inactivity, obesity, hypertension, diabetes, and lipid disorders. There was a substantial increasing trend of corpus uteri cancer, with the largest AAPC in incidence found in Japan, followed by India, Chile, Korea, and Thailand. CONCLUSION: The incidence and mortality of corpus uteri cancer have been increasing substantially for the past 10 years. Intensive lifestyle modifications are needed, especially among younger women.

Global Trends of Prostate Cancer by Age, and Their Associations With Gross Domestic Product (GDP), Human Development Index (HDI), Smoking, and Alcohol Drinking.

BACKGROUND: We aimed to examine the global disease burden and trends of prostate cancer incidence and mortality by age, and their associations with gross domestic product (GDP), human development index (HDI), smoking, and alcohol drinking. MATERIALS AND METHODS: We retrieved the Global Cancer Observatory (GLOBOCAN) database for the incidence and mortality of prostate cancer in 2020; the World Bank for GDP per capita; the United Nations for HDI; the WHO Global Health Observatory for prevalence of smoking and alcohol drinking; the Cancer Incidence in 5 Continents (CI5), WHO mortality database, for trend analysis. We presented the prostate cancer incidence and mortality using age-standardized rates. We examined their associations with GDP, HDI, smoking, and alcohol drinking by Spearman's correlations and multivariable regression. We estimated the 10-year trend of incidence and mortality by joinpoint regression analysis with average annual percent change with 95% confidence intervals in different age groups. RESULTS: A wide variation in the burden of prostate cancer with the highest mortality found in low-income countries while the highest incidence was observed in high-income countries. We found moderate to high positive correlations for GDP, HDI, and alcohol drinking with prostate cancer incidence, whilst a low negative correlation was observed for smoking. Globally, there was an increasing incidence but decreasing mortality of prostate cancer, and such trends were particularly prominent in Europe. Notably, the incidence increase was also found in the younger population aged <50 years. CONCLUSIONS: There was a global variation in the burden of prostate cancer associated with GDP, HDI, smoking, and alcohol drinking.

Global Incidence, Risk Factors, and Temporal Trends of Mesothelioma: A Population-Based Study.

INTRODUCTION: Mesothelioma is an uncommon type of cancer which has received little attention. This study aims to evaluate the global disease burden; trends of mesothelioma by age, sex, and geographic locations; and its risk factors on the population level. METHODS: The Global Cancer Observatory, Cancer Incidence in Five Continents Plus, and Global Burden of Disease were accessed for mesothelioma incidence and its risk factors worldwide. The associations between mesothelioma incidence and asbestos were evaluated for each country by multivariable linear regression analysis by sex and age. Average annual percentage change (AAPC) was calculated using Joinpoint regression to evaluate the epidemiologic trends of mesothelioma. RESULTS: The age-standardized rate of mesothelioma was 0.30 per 100,000 persons with Northern Europe reporting the highest incidence rates. The incidence rate of the male population was much higher than that of the females. Countries with higher human development index (ß = 0.119, confidence interval [CI]: 0.073-0.166, p < 0.001), gross domestic product per capita (ß = 0.133, CI: 0.106-0.161, p < 0.001), and asbestos exposure (ß = 0.087, CI: 0.073-0.102, p < 0.001) had higher mesothelioma. The overall trend of mesothelioma incidence was decreasing, although an increase was observed in Bulgaria (AAPC: 5.56, 95% CI: 2.94-8.24, p = 0.001) and Korea (AAPC: 3.24, 95% CI: 0.08-6.49, p = 0.045). CONCLUSIONS: There was a substantial declining incidence trend of mesothelioma in the past decade possibly related to the restriction of the use of asbestos in some countries. Meanwhile, the increasing trend in mesothelioma incidence observed in females might be indicative of an increase in environmental exposure to mineral fibers.

Incidence and mortality of thyroid cancer in 50 countries: a joinpoint regression analysis of global trends.

PURPOSE: To evaluate the incidence and mortality trend of thyroid cancer, and compare its global incidence trends among different countries by age group and sex. METHODS: Data on age-standardized incidence and mortality rate of thyroid cancer among 50 countries were collected from the Cancer Incidence in Five Continents Volume XI; the Surveillance, Epidemiology, and End Results Program (SEER), the National Cancer Institute; the Nordic Cancer Registries (NORDCAN), and the WHO mortality database. The Average Annual Percent Change (AAPC) of the incidence and mortality trends was calculated by joinpoint regression analysis. RESULTS: The age-standardized incidence of thyroid cancer was 3.1 and 10.1 cases per 100,000 persons in men and women, respectively. The incidence of thyroid cancer increased in most countries among individuals irrespective of age groups, and increased in populations aged <40 years in several countries, including Korea (male: AAPC 25.3, 95% C.I. 22.3-28.4, p < 0.001; female: AAPC 18.5, 95% C.I. 16.2-20.9, p < 0.001), Poland (male: AAPC 19.1, 95% C.I. 1.4-39.7, p = 0.036; female: AAPC 13.7, 95% C.I. 7.6-20.2), and China (male: AAPC 18.6, 95% C.I. 12.1-25.5, p < 0.001; female: AAPC 13.3, 95%C.I. 11.5-15.1, p < 0.001). CONCLUSION: An increasing incidence of thyroid cancer was observed in younger subjects in a majority of countries, highlighting the need for more preventive strategies in this population and possible avoidance of over-diagnosis.

Global incidence, mortality and temporal trends of cancer in children: A joinpoint regression analysis.

BACKGROUND/METHODS: The Cancer Incidence in Five Continents Time Trends, Nordic Cancer Registries, Surveillance, Epidemiology and End Results, WHO Mortality databases were assessed to extract the Age-Standardised Rates (ASR) of cancer incidence and mortality among children aged 0-14 years old. By using the ASRs, the country-specific Average Annual Percentage Change (AAPC) and its corresponding 95% confidence interval (CI) were calculated to determine the epidemiological cancer trend. RESULTS: In 2020, the highest incidence of childhood cancer was found in countries with higher Human Development Index (HDI) (ASR = 15.7), yet the highest mortality was found in countries with lower HDIs (ASR = 4.8). As for incidence, seven countries had positive AAPC among boys; Slovakia (AAPC2001-2010  = 4.98, 95% CI [1.66-8.40]), Ecuador (AAPC2003-2012  = 4.07, 95% CI [0.67-7.59]) and Thailand (AAPC2003-2012  = 3.69, 95% CI [0.37-7.11]) had the highest AAPC. Among girls, three countries had positive AAPC, which included Belarus (AAPC2003-2012  = 3.18, 95% CI [1.11, 5.29]), Canada (AAPC2003-2012  = 2.83, 95% CI [1.60, 4.07]) and Korea (AAPC2003-2012  = 1.76, 95% CI [0.23-3.32]). There was an overall decreasing trend of mortality. However, increased mortality was observed in two countries: Ecuador for boys (AAPC2007-2016  = 1.72, 95% CI [0.27-3.19]) and Austria for girls (AAPC2008-2017  = 4.11, 95% CI [0.38-7.98]). CONCLUSIONS: The largest mortality and mortality to incidence ratio of childhood cancer were found in low-income countries. There was a substantial increasing trend of childhood cancer incidence, while overall its mortality has been decreasing over the past decade. More studies are needed to confirm the drivers behind these epidemiologic trends.

Disease burden, risk factors, and trends of primary central nervous system (CNS) cancer: A global study of registries data.

BACKGROUND: This study aimed to evaluate the global incidence, mortality, associated risk factors, and temporal trends of central nervous system (CNS) cancer by sex, age, and country. METHODS: We extracted incidence and mortality of CNS cancer from the GLOBOCAN (2020), Cancer Incidence in Five Continents series I-X, WHO mortality database, the Nordic Cancer Registries, and the Surveillance, Epidemiology, and End Results Program. We searched the Global Health data exchanges for the prevalence of its associated risk factors. We tested the trends by Average Annual Percentage Change (AAPC) from Joinpoint regression analysis with 95% confidence intervals in different age groups. RESULTS: The age-standardized rates (ASRs) of CNS cancer incidence and mortality were 3.5 and 2.8 per 100,000 globally. Southern Europe (ASR = 6.0) and Western Asia (ASR = 4.2) had the highest incidence and mortality, respectively. The incidence was associated with Human Development Index, Gross Domestics Products per capita, prevalence of traumatic brain injuries, occupational carcinogens exposure, and mobile phone use at the country level. There was an overall stable and mixed trend in the CNS cancer burden. However, increasing incidence was observed in younger male population from five countries, with Slovakia (AAPC = 5.40; 95% CI 1.88, 9.04; P = .007) reporting the largest increase. CONCLUSIONS: While the overall global trends of cancer have been largely stable, significant increasing trends were found in the younger male population. The presence of some higher-HDI countries with increasing mortality suggested an ample scope for further research and exploration of the reasons behind these epidemiological trends.

Global burden and temporal trends of lower urinary tract symptoms: a systematic review and meta-analysis.

BACKGROUND: Lower urinary tract symptoms (LUTS) are common complaint in urology practice and affecting the quality of life for patients. This article aims to perform a systematic review and meta-analysis on the global prevalence of LUTS overall, and according to different patient characteristics. METHODS: We searched MEDLINE and Embase for population-based epidemiological studies reporting the prevalence of LUTS from inception to 1 Jan 2021. Studies which: (1) have enough information on sample size and prevalence; (2) investigate individuals aged 15 or above; and (3) have clear diagnostic criteria for LUTS. We extracted the following information: year of publication; name of the first author; study period; region of recruitment; race; age range; sex; severity; symptoms; and criteria. We pooled rate estimates with exact binomial and test score-based confidence intervals (CIs) using proportions with a random-effects model. RESULTS: We included 222 studies from 36 countries involving 1,692,110 samples and 632,933 patients with LUTS. The overall prevalence of any and moderate-to-severe LUTS was 63.2% (95% CI = 58.0-68.1) and 31.3% (95% CI = 28.8-33.8), respectively. The most common symptom was storage symptoms (56.7%; 95% CI = 51.0-62.4), followed by voiding symptoms (36.4%; 95% CI = 27.8-45.4) and post-micturition symptoms (30.7%; 95% CI = 19.2-43.6). A higher prevalence of moderate-to-severe LUTS was observed in male subjects (35.2%; 95% CI = 32.1-38.5) and individuals aged ≥60 (39.0%; 95% CI = 33.4-44.8; I2 = 99.9%). Its prevalence increased from 27.4% (95% CI = 24.5-30.3) in 1990-1999, to 31.9% (95% CI = 27.3-36.7) in 2000-2009 and 36.2% (95% CI = 30.7-41.9) in 2010-2019. CONCLUSIONS: This study was the first comprehensive meta-analysis examining the global prevalence of LUTS. We identified a high level of LUTS prevalence in the general population, with a higher burden in male subjects, older individuals, and the Asian population. There has been an increasing trend in the prevalence of LUTS since the 1990s.

Disease Burden, Risk Factors, and Trends of Leukaemia: A Global Analysis.

Leukaemia accounted for approximately 2.5% of all new cancer incidence and 3.1% of cancer-related mortality. The investigation of its risk factors and epidemiologic trends could help describe the geographical distribution and identify high-risk population groups. This study aimed to evaluate the global incidence, mortality, associated risk factors, and temporal trends of leukaemia by sex, age, and country. We extracted incidence and mortality of leukaemia from GLOBOCAN, CI5, WHO mortality database, NORDCAN, and SEER. We searched the WHO Global Health Observatory data repository for the age-standardised prevalence of lifestyle and metabolic risk factors. We tested the trends by calculating Average Annual Percentage Change (AAPC) from Joinpoint regression. The age-standardized rate of incidence and mortality were 5.4 and 3.3 per 100,000 globally. The incidence and mortality of leukaemia were associated with Human Development Index, Gross Domestics Products per capita, prevalence of smoking, physical activity, overweight, obesity, and hypercholesterolaemia at the country level. Overall, more countries were showing decreasing trends than increasing trends in incidence and mortality. However, an increasing trend of leukaemia incidence was found in Germany, Korea, Japan, Canada and the United Kingdom (AAPC, 2.32-0.98) while its mortality increased in the Philippines, Ecuador, Belarus, and Thailand (AAPC, 2.49-1.23). There was a decreasing trend of leukaemia for the past decade while an increase in incidence and mortality was observed in some populations. More intensive lifestyle modifications should be implemented to control the increasing trends of leukaemia in regions with these trends. Future studies may explore the reasons behind these epidemiological transitions.

The epidemiological landscape of multiple myeloma: a global cancer registry estimate of disease burden, risk factors, and temporal trends.

BACKGROUND: Multiple myeloma accounted for 176 404 (14%) of 1 278 362 the incidence cases leukaemia, lymphoma, and multiple myeloma in 2020. Identifying its geographical distribution, risk factors, and epidemiological trends could help identify high-risk population groups. We aimed to examine the worldwide incidence, mortality, associated risk factors, and temporal trends of multiple myeloma by sex, age, and geographical region. METHODS: The incidence and mortality of multiple myeloma were extracted from Global Cancer Observatory (2020), Cancer Incidence in Five Continents, WHO mortality database, Nordic Cancer Registries, and Surveillance, Epidemiology, and End Results Program (1980-2019). The WHO Global Health Observatory data repository was searched for the age-standardised prevalence of lifestyle and metabolic risk factors (2010). Associations with risk factors were examined by multivariable regression. The temporal trends were evaluated by average annual percentage change (AAPC) using joinpoint regression. FINDINGS: The age-standardised rate (ASR) of multiple myeloma incidence was 1·78 (95% UI 1·69-1·87) per 100 000 people globally and mortality was 1·14 (95% UI 1·07-1·21) per 100 000 people globally in 2020. Increased incidence and mortality were associated with higher human development index, gross domestics product, prevalence of physical inactivity, overweight, obesity, and diabetes. Australia and New Zealand (ASR 4·86 [4·66-5·07]), northern America (4·74 [4·69-4·79]), and northern Europe (3·82 [3·71-3·93]) reported the highest incidence. The lowest incidences were observed in western Africa (0·81 [0·39-1·66]), Melanesia (0·87 [0·55-1·37]), and southeastern Asia (0·96 [0·73-1·27]). Overall, more countries had an increase in incidence, especially in men aged 50 years or older. The countries with the highest incidence increase in men older than 50 years were Germany (AAPC 6·71 [95% CI 0·75-13·02] p=0·027), Denmark (3·93 [2·44-5·45] p=0·00027), and South Korea (3·25 [0·69-5·88] p=0·019). For women aged 50 years or older, Faroe Islands (21·01 [2·15-43·34] p=0·032), Denmark (4·70 [1·68-7·82], p=0·0068), and Israel (2·57 [0·74-4·43] p=0·012) reported the greatest increases. Overall, there was a decreasing trend for multiple myeloma mortality. The highest mortality was observed in Polynesia (ASR 2·69 [0·74-9·81]), followed by Australia and New Zealand (1·84 [1·73-1·96]) and northern Europe (1·80 [1·73-1·88]). The lowest mortalities were reported in southeastern Asia (ASR 0·82 [0·62-1·09]), eastern Asia (0·76 [0·71-0·81]), and Melanesia (0·73 [0·61-0·87]). Men (1·41 [1·29-1·53]) were found to have mortality higher than women (0·93 [0·85-1·02]). INTERPRETATION: There was an increasing trend of multiple myeloma incidence globally, particularly in men, people aged 50 years or older, and those from high-income countries. The overall decreasing global trend of multiple myeloma mortality was more evident in women. Lifestyle habits, diagnosis capacity, and treatment availability should be improved to control the increasing trends of multiple myeloma in high-risk populations. Future studies should explore the reasons behind these epidemiological transitions. FUNDING: None.

Worldwide Distribution, Risk Factors, and Temporal Trends of Testicular Cancer Incidence and Mortality: A Global Analysis.

BACKGROUND: Testicular cancer is a common malignancy among young males in western countries. OBJECTIVE: To examine the global disease burden and trends of testicular cancer incidence and mortality by age and country, and their associations with human development index (HDI), gross domestic product (GDP), lifestyle habits, and metabolic risk factors. DESIGN, SETTING, AND PARTICIPANTS: We retrieved the Global Cancer Observatory database for the testicular cancer incidence and mortality in 2020; the World Bank for GDP per capita; the United Nations for HDI; the WHO Global Health Observatory for prevalence of smoking and alcohol drinking; and the Cancer Incidence in Five Continents, WHO mortality database, Surveillance, Epidemiology, and End Results programme and Nordic Cancer Registries (NORDCAN) for trend analysis. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We presented the testicular cancer incidence and mortality using age-standardised rates. We examined their associations with HDI, GDP, smoking, alcohol drinking, physical inactivity, overweight, obesity, and medical conditions including diabetes, hypertension, and hypercholesterolaemia by linear regression. We estimated the 10-yr trend of incidence and mortality by joinpoint regression with average annual percentage change with 95% confidence intervals in different age groups. RESULTS AND LIMITATIONS: There was a wide variation in the testicular cancer burden with the highest mortality found in low-income countries, and the regions of Central America and South America, while the highest incidence was observed in high-income countries, especially in Western and Northern Europe. We found a positive association for HDI, GDP, alcohol drinking, inactivity, overweight, obesity, and hypercholesterolaemia with testicular cancer incidence, while a negative correlation was observed between GDP and mortality of testicular cancer. Globally, there was an overall increasing incidence trend of testicular cancer for the past decade, particularly in younger males; the mortality trends of testicular cancer were relatively stable. However, we did not analyse the trend of different stages and subtypes of testicular cancer due to data unavailability. CONCLUSIONS: There was a global variation in the testicular cancer burden associated with HDI, GDP, alcohol drinking, inactivity, overweight, obesity, and hypercholesterolaemia. Testicular cancer had an increasing incidence but decreasing mortality. The increasing testicular cancer incidence in the younger population is of concern and calls for early detection and preventive interventions. PATIENT SUMMARY: Globally, testicular cancer incidence had been increasing particularly in the younger population, although its deaths rates had been decreasing. Socioeconomic indices, alcohol drinking, inactivity, overweight, obesity, and high plasma lipid levels are associated with testicular cancer incidence and mortality.

Cancer Incidence and Mortality in Asian Countries: A Trend Analysis.

BACKGROUND: This study aimed to evaluate the updated burden and temporal trends of cancer incidence and mortality in Asian countries. METHODOLOGY: The data used in this study were retrieved from the Global Cancer Observatory, Cancer Incidence in Five Continents volumes I-XI, and the World Health Organization mortality database. These data were used to calculate the Average Annual Percentage Change (AAPC), with a 95% confidence interval (CI) by joinpoint regression analysis to determine the epidemiological trend in the past decade. RESULTS: In 2020, the cancer incidence in Asia was 169.1 per 1 00 000, accounting for 49.3% of the global cancer incidence. The most common cancers included lung (13.8%), breast (10.8%) and colorectal (10.6%) cancers. Its mortality was 101.6 per 1 00 000 (58.3% of the global cancer death) with lung (19.2%), liver (10.5%) and stomach (9.9%) cancers being the most common causes of cancer death. The cancer incidence had been increasing in female population, with Korea (AAPC = 5.73, 95% CI [5.30, 6.17], P < .001), Japan (AAPC = 2.67, 95% CI [2.12, 3.23], P < .001) and Kuwait (AAPC = 2.08, 95% CI [.49, 3.69], P = .016) showing the most significant increases in the past decade. The incidence increase was also observed among population aged <40 years old, with Korea (female AAPC = 8.42, 95% CI [7.40, 9.45], P < .001; male AAPC = 5.28, 95% CI [4.23, 6.33], P <.001), China (female AAPC = 2.94, 95% CI [2.07, 3.81], P < .001; male AAPC = 1.37, 95% CI [.57, 2.18], P = .004) and Japan (female AAPC = 2.88, 95% CI [1.88, 3.88], P = .016; male AAPC = 1.59, 95% CI [.40, 2.78], P = .015) showing the most significant increases. However, there was an overall decreasing trend of cancer mortality. CONCLUSIONS: There was a substantial burden of cancer incidence and mortality in Asia. Although there was a decreasing trend in cancer mortality, its incidence had been increasing especially among female and younger populations. Future studies could be done to further investigate the potential reasons for these epidemiologic trends.

Incidence, mortality, risk factors, and trends for Hodgkin lymphoma: a global data analysis.

BACKGROUND: Hodgkin lymphoma is a lymphatic malignancy commonly found in cervical lymph nodes. This study evaluated the worldwide incidence, mortality, associated risk factors, and temporal trends of Hodgkin lymphoma by sex, age, and country. METHODS: The age-standardised Hodgkin lymphoma incidence and mortality were retrieved from the GLOBOCAN, CI5 volumes I-XI, WHO mortality database, the NORDCAN and SEER Program. The age-standardised prevalence of smoking, alcohol drinking, obesity, and hypertension was also extracted for each country. Trends were tested using Average Annual Percentage Change (AAPC) from Joinpoint regression analysis. RESULTS: The Hodgkin lymphoma incidence and mortality were 0.98 and 0.26 per 100,000 in 2020. A higher incidence was observed in high-income countries, while higher mortality was found in low-income countries. Incidence and mortality were associated with GDP per capita, prevalence of smoking, obesity, and hypertension at the population level. Despite the decreasing mortality trend, there was an increasing incidence, especially among females, younger population, and subjects from Asian countries. CONCLUSIONS: There was an increasing trend in Hodgkin lymphoma incidence, especially among subjects who were female, younger population, and from Asian countries. Further studies are needed to investigate the reasons for these epidemiologic trends.