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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.
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Neoplasias Oculares , Saúde Global , Sistema de Registros , Humanos , Fatores de Risco , Incidência , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias Oculares/epidemiologia , Neoplasias Oculares/mortalidade , Idoso , Distribuição por Sexo , Adulto , Distribuição por Idade , Efeitos Psicossociais da Doença , Prevalência , Idoso de 80 Anos ou mais , Adolescente , Taxa de Sobrevida/tendênciasRESUMO
Enhanced recovery after surgery (ERAS) protocols represent patient-centered, evidence-based, multidisciplinary care of the surgical patient. Although these patterns have been validated in numerous surgical specialities, ERAS has not been widely described for patients undergoing hip fracture (HFx) repair. As part of the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery, we have conducted a full evidence review of interventions that form the basis of the anesthesia components of the ERAS HFx pathway. A literature search was performed for each protocol component, and the highest levels of evidence available were selected for review. Anesthesiology components of care were identified and evaluated across the perioperative continuum. For the preoperative phase, the use of regional analgesia and nonopioid multimodal analgesic agents is suggested. For the intraoperative phase, a standardized anesthetic with postoperative nausea and vomiting prophylaxis is suggested. For the postoperative phase, a multimodal (primarily nonopioid) analgesic regimen is suggested. A summary of the best available evidence and recommendations for inclusion in ERAS protocols for HFx repair are provided.
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Anestesiologia/métodos , Anestesiologia/normas , Artroplastia de Quadril/métodos , Fraturas do Quadril/cirurgia , Analgésicos/uso terapêutico , Anestésicos/efeitos adversos , Anestésicos/uso terapêutico , Medicina Baseada em Evidências , Humanos , Comunicação Interdisciplinar , Bloqueio Nervoso , Manejo da Dor , Segurança do Paciente , Assistência Centrada no Paciente , Assistência Perioperatória/métodos , Período Perioperatório , Ensaios Clínicos Controlados Aleatórios como Assunto , Estados Unidos , United States Agency for Healthcare Research and QualityRESUMO
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.
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Neoplasias de Cabeça e Pescoço , Neoplasias Laríngeas , Humanos , Masculino , Feminino , Neoplasias Laríngeas/epidemiologia , Fatores de Risco , Neoplasias de Cabeça e Pescoço/epidemiologia , Incidência , Saúde Global , Sistema de RegistrosRESUMO
This study aimed to examine the cost-effectiveness of fecal biomarker M3 panel compared to fecal immunochemical test (FIT) and colonoscopy in an Asian population. In a hypothetical population of 100,000 persons aged 50 years who received FIT yearly, M3 biomarker yearly, or colonoscopy every 10 years until the age of 75 years. Participants with positive FOBT or a result of "high risk" identified using the M3 biomarker are offered colonoscopy. We assumed surveillance colonoscopy is repeated every 3 years, and examined the treatment cost. A comparison of various outcome measures was conducted using Markov modelling. The incremental cost-effectiveness ratio (ICER) of FIT, M3 biomarker, and colonoscopy was USD108,176, USD133,485 and USD159,596, respectively. Comparing with FIT, the use of M3 biomarker could lead to significantly smaller total loss of cancer-related life-years (2783 vs. 5279); a higher number of CRC cases prevented (1622 vs. 146), a higher proportion of CRC cases prevented (50.2% vs. 4.5%), more life-years saved (2852 vs. 339), and cheaper total costs per life-year saved (USD212,553 vs. 773,894). The total costs per life-year saved is more affordable than that achieved by colonoscopy as a primary screening tool (USD212,553 vs. USD236,909). The findings show that M3 biomarkers may be more cost-effective than colonoscopy.
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In January 2021, the eHealth App was launched in Hong Kong by the Hong Kong government to support the Electronic Health Record Sharing System (eHRSS). A Health Management Module in the eHealth App introduced new functions to record blood pressure, blood sugar, and heart rate, and downloading and sharing records. This study aims to compare the level of glycaemic control between users of the eHealth App and non-users. Type 2 diabetes patients who have joined the eHRSS with existing haemoglobin A1c (HbA1c) level records are recruited. Correlations between predictors and optimal HbA1c control (<7%) are examined using logistic regression analyses. A total of 109,823 participants are included, with 76,356 non-users of eHealth App, 31,723 users of eHealth App, and 1744 users of the eHealth Management Module together with the App. We collect HbA1c values from Jan 2021 to May 2022, and they are 6 months after the use of the App on average. Users of the eHealth Management Module are found to have more optimal HbA1c levels across all subgroups, with the strongest effect observed in younger females (aOR = 1.66, 95% CI = 1.27-2.17). eHealth App usage is also positively associated with optimal HbA1c levels, particularly amongst younger females (aOR = 1.17, 95% CI = 1.08-1.26). Overall, users of eHealth App and eHealth Management Module demonstrate more optimal HbA1c levels when compared with non-users, particularly among younger adults and females. These findings support its potential adoption in diabetes patients. Future studies should examine the impact of eHealth interventions on other clinical targets and diabetes complications.
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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.
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Melanoma , Neoplasias Cutâneas , Masculino , Feminino , Humanos , Idoso , Pessoa de Meia-Idade , Incidência , Melanoma/epidemiologia , Fatores de Risco , Neoplasias Cutâneas/epidemiologia , Sistema de Registros , Saúde GlobalRESUMO
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.
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Lábio , Neoplasias Faríngeas , Masculino , Humanos , Feminino , Idoso , Neoplasias Faríngeas/epidemiologia , Neoplasias Faríngeas/etiologia , Fatores de Risco , Incidência , Efeitos Psicossociais da Doença , Sistema de Registros , Saúde GlobalRESUMO
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has resulted in changes in lifestyle habits and experiences of mental health outcomes, some of which were possibly related to weight gain, leading to an increase in the prevalence of obesity, which is associated with the development of several severe diseases. Concerns regarding weight gain and its impact on health outcomes are prevalent worldwide, with obesity being one of the highest causes of mortality in current society. METHODS: A self-reported questionnaire collected data from participants aged 18 years of age and above from 26 countries and regions worldwide. Post-hoc multiple logistic regression analyses have been done to evaluate the association between demographic and socioeconomic factors, and the perspectives that were identified to be associated with weight gain. RESULTS: Participants belonging to a younger age group; with a higher level of education; living in an urban area; living with family members; employed full-time; and had obesity were found to be more vulnerable to weight gain. After adjusting for socio-demographic factors, participants who were quarantined; exercised less prior to the pandemic; consumed unhealthy foods; and reported negative thoughts such as helplessness and the perceived risk of COVID-19, were more likely to experience weight gain; while negative thoughts such as having no means of control over the COVID-19 pandemic and the consequences of the COVID-19 pandemic will have great personal effect were associated with females, students, and people living in the rural area. CONCLUSIONS: Weight gain risk during the pandemic was significantly associated with certain socio-demographic and COVID-19 related factors. To improve public health outcomes, future research should conduct a longitudinal evaluation on the effects of COVID-19 experiences upon health choices. Streamlined mental support should also be provided to the vulnerable groups which were prone to negative thoughts that were associated with weight gain.
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COVID-19 , Feminino , Humanos , Adolescente , COVID-19/epidemiologia , Pandemias , SARS-CoV-2 , Aumento de Peso , Obesidade/epidemiologiaRESUMO
Invasive pneumococcal disease (IPD) is a leading cause of disability and mortality worldwide, particularly in the elderly population. With the implementation of the Government Vaccination Programme (GVP) and the Vaccination Subsidy Scheme (VSS), enabling factors and barriers in service provider scheme participation and vaccination uptake were examined in 32 interviews with doctors and 16 interviews with vaccine recipients. Interview data were analysed in NVivo 11.0 with reference to the Consolidated Framework for Implementation Research (CFIR) and the REAIM Framework to develop codes and themes. Barriers to pneumococcal vaccination uptake included concerns on vaccine efficacy and poor understanding of the disease and vaccine schemes, whilst service provider participation was hindered by ill-defined parameters for patient eligibility and time, location, and logistical constraints. Enabling factors to improve intervention implementation were involvement of the government and physicians to encourage participation, clarifying eligibility criteria, and improving individual knowledge of IPD and vaccination schemes. As participation rates in the GVP and VSS remains low in Hong Kong, efforts concentrating on health promotion strategies encouraging pneumococcal vaccination amongst the elderly population are recommended.
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Several vaccines have been developed for COVID-19 since the pandemic began. This study aimed to evaluate the factors associated with COVID-19 vaccination intention. A global survey was conducted across 26 countries from October, 2020 to December, 2021 using an online self-administered questionnaire. Demographic information, socio-economic status, and clinical information were collected. A logistic regression examined the associations between vaccine intention and factors such as perceptions and the presence of chronic physical and mental conditions. The sample included 2459 participants, with 384 participants (15.7%) expressing lower COVID-19 vaccination intent. Individuals who identified as female; belonged to an older age group; had a higher level of education; were students; had full health insurance coverage; or had a previous history of influenza vaccination were more willing to receive vaccination. Conversely, those who were working part-time, were self-employed, or were receiving social welfare were less likely to report an intention to get vaccinated. Participants with mental or physical health conditions were more unwilling to receive vaccination, especially those with sickle cell disease, cancer history within the past five years, or mental illness. Stronger vaccination intent was associated with recommendations from the government or family doctors. The presence of chronic conditions was associated with lower vaccine intention. Individuals with health conditions are especially vulnerable to health complications and may experience an increased severity of COVID-19 symptoms. Future research should evaluate the effectiveness of interventions targeting the vaccine perceptions and behaviours of at-risk groups. As such, public awareness campaigns conducted by the government and proactive endorsement from health physicians may help improve COVID-19 vaccination intention.