State Variation in Early-Onset Colorectal Cancer in the United States, 1995-2015.

The extent to which the increase in early-onset colorectal cancer (CRC) in the United States varies geographically is unknown. We analyzed changes in CRC incidence and risk factors among people aged 20-49 years by state using high-quality population-based cancer registry data provided by the North American Association of Central Cancer Registries and national survey data, respectively. Early-onset CRC incidence was mostly stable among blacks and Hispanics but increased in 40 of 47 states among non-Hispanic whites, most prominently in western states. For example, rates increased in Washington from 6.7 (per 100 000) during 1995-1996 to 11.5 during 2014-2015 (rate ratio = 1.73, 95% confidence interval = 1.48 to 2.01) and in Colorado from 6.0 to 9.5 (rate ratio = 1.57, 95% confidence interval = 1.30 to 1.91). Nevertheless, current CRC incidence was highest in southern states. From 1995 to 2005, increases occurred in obesity prevalence in all states and heavy alcohol consumption in one-third of states, but neither were correlated with CRC incidence trends. Early-onset CRC is increasing most rapidly among whites in western states. Etiologic studies are needed to explore early life colorectal carcinogenesis.

Cancer incidence profile in sub-Saharan African-born blacks in the United States: Similarities and differences with US-born non-Hispanic blacks.

BACKGROUND: Sub-Saharan African-born blacks (ABs) are one of the fastest-growing populations in the United States. However, to the authors' knowledge, data regarding the cancer burden in this group are lacking, which would inform targeted cancer prevention and control. METHODS: The authors calculated age-standardized proportional incidence ratios (PIRs) comparing the frequency of the top 15 cancers in ABs with that of US-born non-Hispanic blacks (USBs) by sex and region of birth using incidence data for 2000 through 2012 from the Surveillance, Epidemiology, and End Results (SEER 17) program. RESULTS: Compared with USBs, ABs had significantly higher PIRs of infection-related cancers (liver, stomach, and Kaposi sarcoma), blood cancers (leukemia and non-Hodgkin lymphoma), prostate cancer, and thyroid cancers (females only). For example, the PIR for Kaposi sarcoma in AB versus USB women was 12.06 (95% confidence interval [95% CI], 5.23-18.90). In contrast, ABs had lower PIRs for smoking-related and colorectal cancers (eg, for lung cancer among men, the PIR was 0.30 [95% CI, 0.27-0.34]). Furthermore, cancer occurrence in ABs versus USBs varied by region of birth. For example, the higher PIRs for liver cancer noted among male ABs (PIR, 3.57; 95% CI, 1.79-5.35) and for thyroid cancer in female ABs (PIR, 3.03; 95% CI, 2.03-4.02) were confined to Eastern African-born blacks, whereas the higher PIR for prostate cancer (PIR, 1.90; 95% CI, 1.78, 2.02) was confined to Western African-born blacks. CONCLUSIONS: The cancer incidence profile of ABs is different from that of USBs and varies by region of birth, suggesting differences in environmental, cultural, social, and genetic factors. The findings of the current study could stimulate etiologic research and help to inform targeted interventions. Cancer 2017;123:3116-24. © 2017 American Cancer Society.

On-farm starling populations and other environmental and management factors associated with the presence of cefotaxime and ciprofloxacin resistant E. coli among dairy cattle in Ohio.

Wild birds that forage around livestock facilities have been implicated as vectors of antimicrobial resistant organisms. Although antimicrobial resistant bacteria have been isolated from European starlings (Sturnus vulgaris), their role in the dissemination of antimicrobial resistant elements in livestock facilities needs further investigation. To determine whether on-farm starling density and other factors were associated with the presence of cefotaxime and ciprofloxacin resistant E. coli among dairy cows in Ohio, bovine fecal pats from 150 farms were tested for the presence of cefotaxime and ciprofloxacin resistant E. coli. Each farm was visited twice (during the summer and fall of 2007-2009). Multi-level logistic regression models with a random intercept to account for fecal pats collected within a specific visit to a farm were used to assess the associations. The percentage of samples with cefotaxime and ciprofloxacin resistant E. coli was 13.4% and 13.6%, respectively. The percentage of farms having at least one sample testing positive for cefotaxime and ciprofloxacin resistant E. coli was 56.7% and 48.7%, respectively. The odds of detecting cefotaxime and ciprofloxacin resistant E. coli in the samples was significantly higher in 2007 compared to 2008 and 2009, in fall compared to summer, and from farms closer than 60km to starling night roost sites compared to the farms further than 60km. The presence of starlings during the day had a negative association with the likelihood of detecting cefotaxime resistant E. coli. Presence of calves also had a negative association with the likelihood of detecting both cefotaxime and ciprofloxacin resistant E. coli. European starlings might play a role in the dissemination of antimicrobial resistant agents in livestock facilities related to their daily population movements rather than the specific density of birds on farm during the day.

Dairy cattle management factors that influence on-farm density of European starlings in Ohio, 2007-2009.

Potential dairy farm management and environmental factors that attract European starlings (Sturnus vulgaris) to dairy farms were explored. During the period from 2007 to 2009, 150 dairy farms were each visited twice (once during the summer and again in the fall) and the number of starlings was recorded. Risk factors were assessed for possible association with the number of starlings per milking cow (starling density), using a zero-inflated negative binomial model. Starling density was higher on farms visited in 2007 compared to those visited in 2008 or 2009. The interaction term between feeding method and feeding site was significantly associated with starling density on farm; generally, feeding outdoors was associated with increased starling density. The odds of a zero starling count (compared to a count greater than zero) was higher on farms that removed manure from barns weekly or less frequently than weekly compared to those that removed manure daily or after every milking. The odds of a zero starling count decreased with increasing distance of a farm from the closest night roost. Identifying on farm risk factors that expose farms to starlings will help farmers develop strategies that minimize the number of birds on their farms and thereby reduce physical damage to the farms as well as the potential for pathogen transmission from birds to cattle and humans.

Risk factors associated with the colonization of Ontario layer chicken flocks with Brachyspira species.

Brachyspira species are frequent colonizers of the gastrointestinal tract in a variety of domestic animals, including birds. In chickens, Brachyspira species are associated with a clinical condition known as avian intestinal spirochetosis (AIS), a disease characterized by chronic diarrhoea, weight loss, low egg production, and faecal-stained eggs. The purpose of this study was to identify risk factors associated with the presence of Brachyspira species in Ontario layer chicken flocks. Pooled faecal samples were collected from 89 flocks from 58 farms between August 2010 and February 2011; 52 flocks were classified as dirty flocks (history of downgrades for dirty eggs) and 37 were classified as clean flocks (no history of downgrades for dirty eggs). A questionnaire related to management, biosecurity practices, and antimicrobial use was administered prior to sample collection. Using real-time polymerase chain reaction; 63.5% of the dirty flocks and 24.3% of the clean flocks were positive for Brachyspira species. A logistic regression model with a random effect for farm showed that the odds of Brachyspira species for flocks ≥ 60 weeks of age were higher than for flocks ≤ 34 weeks (OR=9.3; P=0.014). The odds of Brachyspira species in flocks housed in A-frame cages with manure curtains (OR=20.0; P=0.002) and flocks from multi-age farms (OR=8.5; P=0.001) were higher than for flocks in cage-stacked houses and from single-age farms, respectively. The odds of Brachyspira species for flocks housed in barns ≥ 30 years old was lower than for flocks housed in barns ≤ 14 years old (OR=0.1; P=0.002). The calculated intra-class correlation coefficient was 5.6 × 10(-14); the notably low proportion of variation among farms after the fixed effects were included in the model suggests that the farm-level variable (multi-age farm) included in the final model accounted for most of the farm-to-farm variation in Brachyspira presence. Therefore, it is recommended that strict biosecurity, and between-flock decontamination efforts to reduce the infection pressure, be followed on farms with multiple flocks of different ages to avoid transmission of the bacteria between flocks.