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Trends of National and Subnational Incidence of Childhood Cancer Groups in Iran: 1990-2016.

ABSTRACT: Background: Childhood cancer is a double-edged sword, considering its high rate of response to treatment despite a high vulnerability to develop future malignancies in survivors. Thus, multidisciplinary preventive, curative, and supportive strategies must be incorporated in childhood cancer care that require understanding the distribution and trend of cancer in the target population. In this article, we aimed to report the national and subnational trends of childhood cancer incidence in Iran from 1990 to 2016, and mortality/incidence ratio (MIR), which, to our knowledge, have not been reported in previous literature. Method: Data on the incidence and mortality rates were collected from the National and Subnational Burden of Diseases project. We employed a two-stage spatiotemporal model to estimate cancer incidences by sex, age, province, and year based on the primary dataset of national death registration system. National and subnational age and gender-specific trends as well as MIR were calculated. Result: The age-standardized incidence rate had a steady increasing trend for cancers in both female [annual percent change (APC), 1.6%] and male (APC, 2.1%) patients. Not only there was an increasing trend in most provinces but also there was a 40% divergence in age-standardized incidence rate at subnational levels. Leukemia, lymphoma, neoplasms of the central nervous system (CNS), digestive tract, endocrine gland, and urinary tract were the leading causes of cancer comprising more than half of all cancers. There was a remarkable general decrease in MIR by 75% as a proxy of care quality. Conclusion: Regarding the increased trend of childhood cancer incidence, there is an essential need to address the etiologic factors and establish preventive plans for childhood cancers. Despite the favorable outcomes observed in cancer care, commensurate health resource allocation must be applied to diminish the subnational disparities.

SUBMITTER: Shabani M

PROVIDER: S-EPMC6970968 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Background and aimsCancer will soon become the leading cause of death in every country in the twenty-first century. This study aimed to analyze the mortality and morbidity of 29 types of cancer in 204 countries or regions from 1990 to 2019 to guide global cancer prevention and control.MethodsDetailed information for 29 cancer groups was collected from the Global Burden of Disease Study in 2019. The age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) of the 29 cancer groups were calculated based on sex, age, region, and country. In addition, separate analyses were performed for major cancer types.ResultsIn 2019, more than 10 million people died from cancer, which was approximately twice the number in 1990. Tracheal, bronchus, and lung (TBL) cancers collectively showed the highest death rate, and the ASDR of pancreatic cancer increased by 24%, which was cancer with the highest case fatality rate (CFR). The global cancer ASIR showed an increasing trend, with testicular cancer, thyroid cancer, and malignant skin melanoma showing a significant increase. The ASDR and ASIR of cancer in males were about 1.5 times higher than that in females. Individuals over 50 years had the highest risk of developing cancer, with incidences and deaths in this age group accounting for more than 85% of cancers in all age groups. Asia has the heaviest cancer burden due to its high population density, with esophageal cancer in this region accounting for 53% of the total fatalities related to this type of cancer in the world. In addition, the mortality and morbidity of most cancers increased with the increase in the development or socio-demographic index (SDI) in the SDI regions based on the World Bank's Human Development Index (HDI), with cancer characteristics varying in the different countries globally.ConclusionsThe global cancer burden continues to increase, with substantial mortality and morbidity differences among the different regions, ages, countries, gender, and cancer types. Effective and locally tailored cancer prevention and control measures are essential in reducing the global cancer burden in the future.

Project description:BackgroundWesternization and etiologic heterogeneity may play a role in the rising breast cancer incidence in Asian American (AA) women. We report breast cancer incidence in Asian-origin populations.MethodsUsing a specialized Surveillance, Epidemiology, and End Results-9 Plus API Database (1990-2014), we analyzed breast cancer incidence overall, by estrogen receptor (ER) status, and age group among non-Hispanic white (NHW) and AA women. We used age-period-cohort models to assess time trends and quantify heterogeneity by ER status, race and ethnicity, and age.ResultsOverall, breast cancer incidence increased for most AA ethnicities (Filipina: estimated annual percentage change [EAPC] = 0.96%/year, 95% confidence interval [CI] = 0.61% to 1.32%; South Asian: EAPC = 1.68%/year, 95% CI = 0.24% to 3.13%; Chinese: EAPC = 0.65%/year, 95% CI = 0.03% to 1.27%; Korean: EAPC = 2.55%/year, 95% CI = 0.13% to 5.02%; and Vietnamese women: EAPC = 0.88%/year, 95% CI = 0.37% to 1.38%); rates did not change for NHW (EAPC = -0.2%/year, 95% CI = -0.73% to 0.33%) or Japanese women (EAPC = 0.22%/year, 95% CI = -1.26% to 1.72%). For most AA ethnicities, ER-positive rates statistically significantly increased, whereas ER-negative rates statistically significantly decreased. Among older women, ER-positive rates were stable for NHW and Japanese women. ER-negative rates decreased fastest in NHW and Japanese women among both age groups.ConclusionsIncreasing ER-positive incidence is driving an increase overall for most AA women despite declining ER-negative incidence. The similar trends in NHW and Japanese women (vs other AA ethnic groups) highlight the need to better understand the influences of westernization and other etiologic factors on breast cancer incidence patterns in AA women. Heterogeneous trends among AA ethnicities underscore the importance of disaggregating AA data and studying how breast cancer differentially affects the growing populations of diverse AA ethnic groups.

Project description:BackgroundBladder cancer is a leading cause of cancer-related deaths all over the world. Epidemiological studies of bladder cancer are therefore crucial for policy making. This study was carried out to describe the characteristics of changes in the incidence and mortality of bladder cancer from 1990 to 2016 by age group, gender, geographical region, and sociodemographic index (SDI) and to simultaneously project future trends up to 2030.MethodsIncidence and mortality trends in bladder cancer from 1990 to 2016 were described based on data and methodologies from the Global Burden of Disease (GBD) Study. The data also allowed the future trends of bladder cancer incidence and mortality to be predicted by ARIMA model. Trends were analyzed by age group, gender, and SDI. Projections to 2030 were sub-analyzed by SDI countries. R software (x64 version 3.5.1), SAS (version 9.3), and SPSS (version 22.0) were used throughout the process.ResultsGlobally, in 2016, there were 437,442 [95% uncertainty interval (UI), 426,709-447,912] new bladder cancer cases and 186,199 (95% UI, 180,453-191,686) bladder cancer-associated deaths. Between 1990 and 2016, changes in the age-standardized incidence rate (ASIR) of bladder cancer decreased by 5.91% from 7.11 (95% UI, 6.93-7.27) in 1990 to 6.69 (95% UI, 6.52-6.85) in 2016. The age-standardized death rate (ASDR) decreased from 3.58 (95% UI, 3.49-3.68) to 2.94 (95% UI, 2.85-3.03) over the same period of time. In future, the greatest occurrence of bladder cancer will be in high SDI countries, followed by high-middle SDI countries. Moreover, bladder cancer incidence rates may increase substantially in middle SDI countries, while the incidence rates will remain relatively stable for men and women in other SDI countries. From 2017 to 2030, bladder cancer deaths will continue to increase in low SDI countries, while deaths in other SDI countries will continue to decrease.ConclusionsThere was a regional difference in the incidence and mortality trends of bladder cancer between 1990 and 2016. Overall, the situation is not optimistic. From 2017 to 2030, the incidence of bladder cancer will continue to rise, especially in high and high-middle SDI countries, where decision-makers should propose appropriate policies on the screening and prevention of bladder cancer.

Project description:BACKGROUND:Childhood cancers represent a small proportion of all cancers but are still a major public health problem. The study analysed long-term trends in childhood cancer incidence and survival in Estonia in relation to societal and health care transition. METHODS:Data on all malignant tumours, diagnosed in children aged 0-14 during 1970-2016, were derived from the Estonian Cancer Registry. Age-standardised (World standard) incidence rates were calculated by ICCC-3 site groups and joinpoint regression was used to estimate annual percentage change (APC) for incidence trends. Cohort and period approach were used to estimate 5-year survival. Internal age standardisation was applied. RESULTS:A total of 1628 incident cancer cases were diagnosed during the study period and overall incidence increased significantly at a rate of 0.5% per year. Significant increases were seen for neuroblastoma and germ cell tumours, for lymphoid leukemias and some CNS sub-sites. At the same time, decline in incidence was seen in almost all subgroups of unspecified neoplasms. The overall 5-year survival improved from 24% in 1970-1979 to 73% in 2010-2016, with the largest changes occurring in the 1990s and 2000s. For many sites, survival increase thereafter has been marginal. CONCLUSION:In this first comprehensive population-based study of childhood cancer incidence and survival in Estonia, long-term trends are shown in the context of societal and health care changes. Even though the increasing incidence of some sites may, at least partially, be explained by improved diagnostics reflected in the decreased incidence of unspecified neoplasms, the overall cancer incidence in children seems to be rising. Rapid progress in diagnosis and care have improved childhood cancer survival immensely, but deficit in Estonia persists compared to other European countries. Results of the study accentuate the need for a more in-depth analysis of clinical data, but also for the prioritization of childhood cancer in Estonia, to ensure access to standard care and innovative treatments.

Project description:BackgroundLeukemias are a group of life-threatening malignant disorders of the blood and bone marrow. The incidence of leukemia varies by pathological types and among different populations.MethodsWe retrieved the incidence data for leukemia by sex, age, location, calendar year, and type from the Global Burden of Disease online database. The estimated average percentage change (EAPC) was used to quantify the trends of the age-standardized incidence rate (ASIR) of leukemia from 1990 to 2017.ResultsGlobally, while the number of newly diagnosed leukemia cases increased from 354.5 thousand in 1990 to 518.5 thousand in 2017, the ASIR decreased by 0.43% per year. The number of acute lymphoblastic leukemia (ALL) cases worldwide increased from 49.1 thousand in 1990 to 64.2 thousand in 2017, whereas the ASIR experienced a decrease (EAPC?=?-?0.08, 95% CI -?0.15, -?0.02). Between 1990 and 2017, there were 55, 29, and 111 countries or territories that experienced a significant increase, remained stable, and experienced a significant decrease in ASIR of ALL, respectively. The case of chronic lymphocytic leukemia (CLL) has increased more than twice between 1990 and 2017. The ASIR of CLL increased by 0.46% per year from 1990 to 2017. More than 85% of all countries saw an increase in ASIR of CLL. In 1990, acute myeloid leukemia (AML) accounted for 18.0% of the total leukemia cases worldwide. This proportion increased to 23.1% in 2017. The ASIR of AML increased from 1.35/100,000 to 1.54/100,000, with an EAPC of 0.56 (95% CI 0.49, 0.62). A total of 127 countries or territories experienced a significant increase in the ASIR of AML. The number of chronic myeloid leukemia (CML) cases increased from 31.8 thousand in 1990 to 34.2 thousand in 2017. The ASIR of CML decreased from 0.75/100,000 to 0.43/100,000. A total of 141 countries or territories saw a decrease in ASIR of CML.ConclusionsA significant decrease in leukemia incidence was observed between 1990 and 2017. However, in the same period, the incidence rates of AML and CLL significantly increased in most countries, suggesting that both types of leukemia might become a major global public health concern.

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Trends of National and Subnational Incidence of Childhood Cancer Groups in Iran: 1990-2016.

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