bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological profile of cancers among adolescent and young adult patients of a Haitian cancer program.
Authors: Bernard Joseph , Constant Pascale , Henderson Rebecca , Alexis Lynn Gabrielle , Gilbert Doukens Patrick , Pierre Lenz Sacha Christyl , DeGennaro Vincent A. 
Published: May 2020

e13589 Background: The epidemiology of cancer among adolescents and young adults (AYA) has been a relatively neglected topic, particularly in the developing countries. The main objective of this study was to present the epidemiology of cancer among this subpopulation in Haiti’s largest cancer program. Methods: A retrospective study was conducted on patients aged 15 to 39 years old with pathological and/or clinical diagnosis of cancer at the cancer clinic of Innovating Health International (IHI) in Port-au-Prince, Haiti from January 2016 to December 2019. The chart review collected variables such as age, gender, date of diagnosis, cancer type and outcome to present this epidemiological profile of AYA cancers. Results: Among the two thousand two hundred and ninety-eight (2298) cancer cases managed during this study period, 20.1% (n = 461) were adolescents and young adults. 82% of these patients were female and 18% male. 25.2% (n = 116) were less than 30 years old. Breast cancer was the most common type (n = 222, 48.2%%), followed by gynecological cancers (n = 70, 15.1%) with cervical cancer representing 61.4% of the cases (n = 43), hematological malignancies (n = 44, 9.5%) with lymphomas (n = 31) as the most common type, sarcomas (n = 43, 9.3%), head and neck cancers (n = 24, 5.2%), gastrointestinal cancers (n = 22, 4.8%), cutaneous cancers (n = 10, 2.2%), urological cancers (n = 5, 1.1%), thyroid cancer (n = 5, 1.1%) and CNS tumors (n = 2, 0.4%). 3.0% of the AYA patients (n = 14) presented with a cancer of unknown primary (CUP). In the < 30 y/o subgroup blood cancers, breast cancer, sarcomas, and head and neck malignancies were respectively the most common types, while in the ≥ 30 y/o subgroup, breast and gynecological cancers were the most common, followed by sarcomas, GI and blood cancers. No case of lung cancer was received for the AYA population. The overall mortality rate was 30.6% and 12.8% of the patients were lost to follow-up. Conclusions: Cancers among AYA patients represented 20.1% of the cancer population, with a different epidemiological profile for the < 30 y/o and ≥ 30 y/o subgroups. The CNS tumors, leukemias and urological cancers were most likely under-represented due to low referral, misdiagnosis or early mortality.
Epidemiology and mortality of metastatic castration-resistant prostate cancer (mCRPC) in a managed care population in the United States.
Authors: Wallace Katrine , Landsteiner Adrienne , Bunner Scott , Engel-Nitz Nicole , Luckenbaugh Amy 
Published: May 2020

e13592 Background: To date, there has been a paucity of information in the literature describing the epidemiology of mCRPC within the prostate cancer population. We present a real-world data study describing characteristics and mortality of patients with mCRPC within an administrative claims database of an insured population within the United States. Methods: In an administrative claims database of ≈18,000,000 covered lives, adult male patients were included if they had ≥1 claim for prostate cancer (ICD-9: 185 or 233.4; ICD-10: C61 or D075), underwent pharmacologic or surgical castration, and had a code for metastatic disease during the identification period (January 1, 2008–March 31, 2018). The index date was the first metastatic claim; 6 months of continuous enrollment (CE) prior to (baseline period) and after (follow-up period) the index date was required. Patients with metastatic claims in the baseline period were excluded. Patients were followed until the earliest of: death (unless prior to the 6-month CE), end of study period, or disenrollment. A claims-based algorithm was employed to identify locally advanced and distant mCRPC patients in the prostate cancer study population. Mortality data were sourced from the Social Security Administration Medicare data, and a claims algorithm. Results: 343,089 patients were identified with a claim for prostate cancer; of those, 3690 mCRPC cases (1.1%) were identified using the claims-based algorithm and met the study inclusion criteria. Median age was 75 years. Insurance type included commercial plans (27%) and Medicare (73%). Castration type included pharmacologic (99%) and surgical (1%). First claims for metastases were most commonly in the bone (65%) or lymph nodes (15%), with 20% in other sites. The study population averaged a Charlson comorbidity index score of 3.05 at baseline, with 16% of patients receiving a score of ≥5. The most common baseline comorbidities were hypertension (67%), urinary disease (58%), dyslipidemia (52%), and cardiac disease (45%). Median follow-up time among the mCRPC group was 538 days, during which 1834 deaths occurred; 50% of the population experienced mortality during the study period. Conclusions: This study provides valuable insights into the epidemiology, clinical characteristics, prevalence rate, and mortality of patients with mCRPC. Given the high mortality proportion of this disease, the development of novel therapies to prolong life in patients with mCRPC is warranted.
Differential effect of obesity on comorbidity risk in younger and older women with early breast cancer.
Authors: Lorentsen Michael , Deal Allison Mary , Muss Hyman B. , Chen Yi Tang , Brenizer Tucker , Shachar Shlomit S. , Nyrop Kirsten A. 
Published: May 2020

e13601 Background: Overall survival in women with early breast cancer (EBC) (Stage I-III) has made great strides over the past several decades, with survivors more likely to die from causes other than breast cancer. This study investigates the differential effect of obesity on pre-treatment comorbidity risk in younger versus older women with EBC. Methods: This is a retrospective chart review of women with EBC, age 21 and older, seen at a single institution. Differences in 18 common comorbidities were assessed by age ( > = 65 vs < 65) and Body Mass Index/BMI ( > = BMI 30 vs < 30), with relative risks (RR) estimated from log-binomial regression. Results: In a sample of 590 women, 24% were age 65+, 32% non-white, and 39% had obesity. Patients age 65+ were more likely to report 2+ comorbidities compared to age < 65 (RR 1.62, 69% v 43%). Obese patients (BMI > = 30) were more likely to report 2+ comorbidities compared to BMI < 30 (RR: 1.73, 66% v 38%). Women with obesity were more likely to have hyperlipidemia (RR: 1.85, 28% v 15%) as well as diabetes (RR: 2.51, 17% v 7%). The impact of BMI on comorbidity risk (2+ v < 2) differed by age group (interaction p < 0.001). In the < 65 group, obese patients were more likely to have 2+ comorbidities compared to non-obese (RR: 2.12, 62% v 29%, p < 0.0001). The difference was not as large in the 65+ group (RR: 1.28, 81% v 63%, p = 0.02). Conclusions: This study demonstrates increased comorbidity burden, including hyperlipidemia and diabetes, in women with obesity and EBC, especially those < 65. Providers should ensure that patients with obesity and EBC are appropriately screened and treated for underlying comorbidities. Future research should assess the impact of weight loss on overall survival in EBC patients.
Pharmacogenetics findings in Brazilian cancer patients.
Authors: Werneck De Carvalho Luis Eduardo , Sarraf Jonathan Souza , Puty Taynah Cascaes , Chaves Juliana Ramos , Câmara Thiago Farias , Yamaguchi Nise Hitomi , Adami Fernando 
Published: May 2020

e13607 Background: Pharmacogenetic is the study of genetic modifications influence on drugs action. Recent studies have suggested that some genetic polymorphisms may have an influence on patient outcomes. Thus, the objective of this thesis is to evaluate the frequency of genetic polymorphisms in cancer patients. Methods: Cross-sectional study at the Oncology Center of São Paulo. The reports presented a SNP evaluation (saliva - PCR-Multiplex, PCR-RFLP or capillary sequencing - Genotypic variants: 1 allele, 2 alleles and no allelic alteration). Polymorphs were validated according to the localized gene and its relationship to drugs using PharmGKB, NCBI SNP Database, NCBI Gene Database and DrugBank Database. Results: Sample mean aging was 49.92 years (SD = 22.73), with breast cancer (n = 26 /% = 26.3) and stage IV (n = 51 /% = 51.6). Among the evaluated platinum components, it is possible to verify that the presence of polymorphisms was more frequent. Of these, all had the highest frequency of polymorphisms in only 1 allele (xpc__rs2228001 = 25.4%; ercc1_rs11615 = 21.2%; xrcc3_rs861539 = 22.2%; mthfr_rs1801133 = 44.4%). This was repeated when evaluating the Cyclophosphamide, Fluoropyrimidines, Taxanes, Anastrozole and Epirubicin-related polymorphisms. When we evaluated the Tamoxifen-related genes, the polymorphisms absence was more frequent (cyp2d6_rs3892097 = 26.3%; cyp3a4_rs2740574 = 61.6%). Evaluating all medications the highest frequency was polymorphism in only 1 allele. Consequently, for the irinotecan drug evaluation, two polymorphisms were evaluated and presence of polymorphism (xrcc3_rs861539 = 58%), mostly in only 1 allele (44%). Conclusions: Therefore we can evaluate that the allelic frequency variability of the polymorphs observed, despite the great variability, shows most evaluated individuals present some type of genotypic modification, being the majority in only 1 allele.
All-cause and cancer mortality in a private health plan in Brazil: Ten years retrospective analysis.
Authors: Reis Neto Joao Paulo , Busch Juliana Martinho , Stefani Stephen D. 
Published: May 2020

e13610 Background: Cancer is the second leading cause of death worldwide. From 2014 to 2015 Brazil estimated more than 500,000 new cases of cancer, which placed the country among those with the highest cancer incidence. This study evaluates the 10-year evolution of mortality rates due to all causes and cancer and to estimate the potential years of life lost (PYLL) in beneficiaries of health plan, according to sex, age and geographic region. Methods: Retrospective cross-sectional, descriptive study evaluated the causes of death, between 2008 and 2017, by sex and age groups, for all causes (AC) and cancer (CA) data from the health insurance system. The information on the death certificates (DC) was coded according to the ICD-10. Age was stratified into groups: up to 49 years, 50–59 years, 60–69 years, 70–79 years and 80 years or more. Data were analyzed by checking the proportions and mortality rates (MR), grouped into two five-year periods, 2008-2012 (P1) e 2013-2017 (P2). Annual MR per 100,000 population was estimated using the direct method and proportional mortality rates (PMR). To calculate the potential years of life lost (PYLL) the upper limit was 76 years old. The avoidable MR was also analyzed for individuals up to 75 years and cancer. Microsoft Excel v2010 and Qlik Sense v13.21 were used to analyze data and statistics. Results: 5,779 deaths were analyzed, 4,447 in men (77.0%, average 70.1 years) and 1,332 women (33%, 75.9 years). Cancer was the second leading cause of death (n = 953, PMR 16.5%), behind cardiovascular disease (n = 1,662 PMR 28.8%). The major crude death rate per 100,000 was due circulatory system diseases (347), followed by cancer (199) and respiratory system diseases (110). The highest cancer MR were in men, elderly and Brazilian regions with the lowest Human Development Index (HDI). Greatest number of deaths in men at P1 were from cancers of lung (CMP 19.8%), prostate (14.2%) and pancreas (8.0%). At P2, prostate (18.2%), lung (16.8%) and stomach (7.6%). In women, during P1, breast (20.2%), lung (13.1%) and pancreas (83%), and during P2, the same order, 22.5%, 14.6% and 9.3%, respectively. Cancer accounted for a total of 6,335 PYLL and 40.9% of causes of death were classified as avoidable. Conclusions: Cancer was one of the leading causes of mortality during the study. High pancreatic cancer MR differs from national statistics, requiring more analysis that involves possible occupational exposure. Although preventive actions for healthy life habits, early screening and diagnosis, Brazil presents high cancer mortality rates as showed in this analysis.
Comorbidities and survival in breast cancer: A retrospective cohort study from an academic institution in southern Illinois.
Authors: Maini Ruby , Regmi Manjari Rani , Parajuli Priyanka , Lara Garcia Odalys Estefania , Cheema Asad , Sahib Hamsa , Tandan Nitin , Koester Cameron , Mirihagalle Noupama , Abedrabo Sabree , Niaz Zurain , Ibrahim Abdisamad M. , Bhandari Bishal , Johnson Alexander , Delfino Kristin , Robinson Kathy , Kulkarni Abhishek , Desai Meghna R. 
Published: May 2020

e13624 Background: Breast cancer is the most common malignancy in females. Early detection and advances in treatment modalities have resulted in decreasing rates of breast cancer related death. While breast cancer survival has improved, risks of death from cardiovascular comorbidities have increased. Our study aims to evaluate survival among breast cancer patients with cardiac comorbidities. Methods: This study was conducted using a retrospective cohort design with use of de-identified hospital electronic patient records. ICD diagnoses codes were used to identify breast cancer patients. Our initial search criteria revealed 1618 patients. Our eligibility criteria included adult patients 18 years and older with newly diagnosed breast cancer from January 1st, 2014 – January 31st, 2017 which yielded 478 patients. All data was collected through retrospective chart review. Analysis was performed with SAS v9.4 software. Qualitative variables were analyzed using Chi-Square Test. Survival curves are estimated using Kaplan-Meier methodology and analyzed with a log rank test. Predictors of survival are assessed with Cox proportional hazards regression analyses. All significance was assumed at the p < 0.05 level and reported as hazard ratios (HR). Results: Of our 478 patients, the following comorbidities were noted: diabetes n = 98 (21.17%), myocardial infarction (MI) n = 14 (2.98%), heart failure (HF) n = 36 (8.38%), coronary artery disease (CAD) n = 26 (5.75%), hypertension (HTN) n = 261 (55.77%), peripheral vascular disease (PVD) n = 9 (1.95%), hyperlipidemia (HLD) n = 230 (49.15%). Survival analysis was completed on patients with CAD (p = 0.49), HLD (p = 0.40), HTN (p = 0.15), MI (p = 0.52), and HF HR = 6.35 (95% CI 2.40-16.7, p = 0.0002). Pre-existing HF had a higher risk of mortality, which was statistically significant; however, all other single comorbidities were not. Overall survival (OS) in patients with more than one comorbidity HR = 1.36 (1.08-1.69, p = 0.006), was statistically significant. Conclusions: Patients with only one comorbidity be it MI, CAD, HTN, HLD did not have statistically significant results in OS. However, breast cancer patients with pre-existing HF are at 6.35-fold higher risk of mortality than those without HF. Patients with more than one comorbidity listed above were at 1.36-fold higher risk of mortality. Our results indicate that risk factor reduction may help improve survival in patients with breast cancer. Prospective validation of these findings is warranted.
Tobacco still haunting Kentuckians: Adolescent and young adult (AYA) cancer trend from the Kentucky SEER database.
Authors: Jacob Aasems , Parasramka Saurabh , Hao Zhonglin , Durbin Eric B. 
Published: May 2020

e13626 Background: Kentucky has the highest incidence and mortality for AYA cancers in the US. When the incidence of AYA cancers increased 4% between 2012-16 nationally, it was 12.3% in the state of Kentucky. Understanding the burden and factors associated with it may help develop effective risk reduction strategies. Methods: SEER database was used for analyzing population estimates (2012-2016) while records from the NCI-designated cancer center in the state was used to assess current trends and clinicopathologic features. Pearson test was used to estimate correlation and Kaplan-Meier and Cox regression models were used to compare survival outcomes. Results: A total of 5825 AYA patients were identified in the state’s SEER database between 2012-16. A majority (62.4%) were female, from non-Appalachian region (71%) and rural counties (64%). Thyroid, breast, melanoma, cervical and CNS malignancies were the most common. While sarcoma, leukemia and gastric cancer decreased in incidence, breast, melanoma, cervical and colorectal cancer have increased from 2012-2016, similar to a general trend nation-wide. County-wise estimation of cancer incidence showed a significant correlation with prevalence of smoking (Pearson r = 0.34, p < 0.001) independent of educational, employment or economic status. A total of 1129 AYA cancer patients treated between 2016-19 at the Markey Cancer Center were analyzed. Baseline characteristics were similar to statewide trend. About 10% of the cancers were metastatic at diagnosis and 14% died from the disease. Nearly half (44%) of the patients were smokers. Smoking was independently associated with higher risk of death (HR 0.46 95%CI 0.33, 0.64, p < 0.0001) and early cancer recurrence (HR 0.56, 95%CI 0.3, 0.9, p = 0.026). Metastatic disease at diagnosis was also more common among smokers compared to non-smokers. (58% vs 41%, p = 0.002). There was no significant difference in OS or risk of recurrence between rural/urban or Appalachian/Non-Appalachian counties. Conclusions: The high prevalence of smoking (24.3%), especially among youth (14.3%) could be the root of the higher incidence of AYA cancers in the state of KY although multiple socio-economic and geographic factors might be influencing. Second-hand smoke exposure at home is also the highest in the country at 32% with rates as high as 80% in some counties. Awareness about these disturbing statistics is required to set in motion more community and legislative interventions to reduce cancer incidence among the youth.
Hematological malignancies in the adolescent and young adult (AYA) population in Singapore.
Authors: Poon Eileen Yi Ling , Wong Evelyn , Goh Wei Lin , Hong Jiancheng , Wong Victoria , Quah Daniel , Tan Yee Pin , Tan Yung Ying , Chan Selene , Chan Jason Yongsheng , Somasundaram Nagavalli , Harunal Rashid Mohamad Farid Rin 
Published: May 2020

e13630 Background: Hematological malignancies is thought to be one of the more common Adolescent and Young Adult (AYA) cancers and constitute leukemias and lymphomas. However, little is known about its incidence and prevalence in Asia. We also do not have any data on its behavior or its prognosticators. The outcomes of this group of patients is also unknown when compared to the pediatrics or geriatrics, but is expected to be not as ideal. There is no consensus on whether this group of patients should be treated as pediatrics or as the older adults. We have sought to evaluate the prevalence and trends in a single large-volume tertiary cancer centre in Asia. Methods: We extracted data on all patients with cancer between 16-39 years old who were seen at our centre (National Cancer Centre Singapore) during the period of 1st January 2015 and 31st December 2019. In total, we had 2583 patients. We then excluded all other cancer types except those with a hematological malignancy and 5 other patients due to incomplete data. Results: There were 319 patients with a hematological malignancy. 153 (48%) were female and 166 were male(52%). Most of the patients presented between 30-39 years old (171, 53.6%). There were 54 (2.1%) leukemias and 265 (83.1%) lymphomas. Of those with leukemias, 46 (85.2%) had acute leukemia and 9 (14.8%) had chronic leukemias. Among the lymphoma patients, there were 194 (73.2%) Non Hodgkin Lymphoma (NHL) patients and 69 (26.0%) Hodgkin Lymphoma (HL) patients. There were 149 (46.7%) B Cell lymphomas and 38 (11.9%) T Cell lymphoma patients. The most common B cell Lymphomas is Diffuse Large B Cell Lymphoma (128, 85.9%) and the most common T Cell Lymphomas is Peripheral T-cell Lymphoma (28, 73.7% patients). Conclusions: AYAs with a hematological malignancy form a significant portion of the cancers we see in this age group. Yet, little information is available with regards to their clinico-pathological characteristics, especially in Asia. Work is underway to further elucidate these differences so that we can better their outcomes.
Comparing breast cancer characteristics and outcomes between black U.S.-born patients and black immigrant patients from individual Caribbean islands.
Authors: Cerbon Danielle , Schlumbrecht Matthew , Ragin Camille , Barreto Coelho Priscila , Hurley Judith , George Sophia 
Published: May 2020

e13633 Background: Caribbean-born black immigrants (CBI) represent 57% of all black immigrants in the US; they come mainly from Haiti, Jamaica, Dominican Republic (DR), and Cuba. Breast cancer (BC) is the leading cause of cancer deaths in women living in the Caribbean, however, our previous retrospective cohort of 1131 black women with BC shows that CBI have a better overall survival compared with US-born black (USB). The Caribbean has a majority of African ancestry; nonetheless, different ancestral populations differ in genetic composition, making the Caribbean a distinct population with several health disparities within it. Therefore, we stratified our study by each Caribbean country compared to USB patients with the objective of further studying the difference in BC outcomes between USB patients and CBI. Methods: We identified BC patients through a Safety Net and Private Hospital Tumor Registries. We selected the most populace sites: Haiti, Jamaica, Bahamas, Cuba and DR; and used data from 1,082 patients to estimate hazard rations (HRs) using Cox proportional hazards regression and Kaplan Meier analysis for overall survival; Chi Squared and independent sample t-test to verify associations in categorical variables. Results: The study has 250 Haitian, 89 Jamaican, 43 Bahamian, 38 Dominican, 38 Cuban and 624 USB women. Haitians underwent less surgery (HB 61.2% vs USB 72.9%; P = 0.001) and had less triple negative BC (18% vs USB 27.8%; P = 0.006). Bahamians were the youngest at diagnosis (50.5 years vs. USB 57.6 P < 0.001) and presented at more advanced stages (stage 3/4, 54.3% vs USB 35.3%; P = 0.02). Jamaicans and DR underwent more radiation therapy (43.8%, P = 0.002 and 44.7%, P = 0.028 vs. USB 28%). Jamaican women had a better overall survival compared to USB patients (median of 154.93 months, 95% CI: 114.1-195.5 vs 98.63 months, 95% CI: 76.4-120.8; Log-Rank Mantel Cox P = 0.034). Favorable factors for survival were: radiation therapy in Haitian and USB (aHR = 0.45, 95% 0.27-0.77; P = 0.004); and surgery in USB (aHR = 0.26 (0.19-0.36), p < 0.001), Bahamians (aHR = 0.05 (0.01-0.47), p = 0.008) and Jamaicans (aHR = 0.08 (0.03-0.24), p < 0.001). Conclusions: This study underlines the vast heterogeneity in the Caribbean population and demonstrates that Jamaican immigrants with BC have a higher overall survival compared to USB patients, proposing that genetic and other cancer related factors inherent to country of origin impact survival within Caribbean immigrants and highlighting the need for further studies in this immigrant sub-group.