bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung cancer gender differences: An analysis of 1599 patients diagnosed between 1996 and 2018.
Authors: Seifi Sharareh , Khosravi Adnan , Salimi Babak , Esfahani Monfared Zahra 
Published: May 2020

e13596 Background: Several studies showed disparities in terms of gender in lung cancer pattern. As we know, there is limited available data from lung cancer trends by gender in Iran and information reported in previous Iranian studies has become outdated. Methods: This observational study included data of Lung Cancer which were obtained from National Institute of Tuberculosis and Lung Disease (NRITLD), Masih Daneshvari Hospital,from January 1, 1996 to June 1, 2018. Overall survival (OS) and progression free survival (PFS) were estimated for each gender at several time points by the Kaplan-Meier method. Results: Characteristics of 1599 patients are shown in Table. Adenocarcinoma was most prevalent pathology in both sex and incidence of this histology increased in men during all study periods except 2002-2006. Notably, Adenocarcinoma has an increasing pattern especially after 2006 in women. Most prevalent Stage was advanced stages in both sex. Mean OS were 9.84±0.56 and 10.27±0.91 months in male and female respectively (P = 0.769). Also, mean PFS was non-significantly longer in men than women (7.6±0.49 vs 7.4±0.39, P = 0.903).Cox regression multivariate analysis showed only significant effect for advanced/extensive stages on OS(P = 0.015). Conclusions: The findings highlight important characteristics of the lung cancer epidemic; women are diagnosed at younger age and were less smoker than men. It is necessary for all chealthcare systems to assess the cancer burden periodically and gender differences should be considered for screening guidelines, preventive strategies, and Treatment. [Table: see text]
Prevalence of pathogenic non-BRCA1/2 gene variants in patients with suspected hereditary breast and ovarian cancer at a referral hospital in northeastern Brazil.
Authors: Sant'Ana Rosane Oliveira , Picanço-Albuquerque Clarissa Gondim , Silva-Fernandes Isabelle Joyce de Lima , Silva Paulo Goberlanio de Barros , Bezerra Maria Júlia Barbosa , Luciano Maria Claudia dos Santos , Lima Marcos Venício Alves 
Published: May 2020

e13602 Background: Breast cancer (BC) is associated with several hereditary syndromes (HS). Patients with clinical criteria for hereditary breast and ovarian cancer (HBOC) should be evaluated for the presence of pathogenic BRCA1/2 variants, although the absence of BRCA1/2 variants does not rule out HS. The purpose of this study was to evaluate the prevalence of pathogenic non- BRCA1/2 variants in patients with suspected HBOC. Methods: Suspected HBOC (NCCN criteria) patients (n = 267) from a Northeastern Brazilian referral cancer hospital were submitted to NGS 31-gene painel. Individuals testing negative for BRCA1/2 mutation (n = 210) remained in the present presentation. Data were analized by the chi-squared test and Fisher’s test ( p< 0.05; SPSS 20.0). Results: Pathogenic/likely pathogenic (P/LP) non- BRCA1/2 variants were detected in 13.3% (n = 28/210) of the patients, all of whom had BC. The most prevalent variant was PALB2 (31%), followed by ATM and MUTYH (14.2%), and TP53 and PMS2 (10.7%). Among these patients 10.7% (n = 3/28) had triple negative tumors. Other gene variants ( BARD1, CHEK2, MLH1, MSH2, PMS1 and XRCC2) were observed at lower frequencies (3.5% each). DNA mismatch repair (MMR)/Lynch syndrome (LS) mutated genes were identified in 4/24 patients with BC. Rare microdeletions were identified in PALB2 (chr16:23652431-23652678 [exons 1-10] and TP53 (chr17:7.573.927-7.579.891 [exons 2-10]) , to our knowledge for the first time in the medical literature (ClinVar). In addition, one patient displayed a double pathogenic variant in ATM (c.67C > T: p.[Arg23*]) and PALB2 (chr16:23652431-23652678 [exons 1-10]). Patients with and without P/LP did not differ with regard to clinical-pathological parameters or therapeutic profile. Conclusions: Patients with suspected HBOC should be evaluated for non- BRCA1/2 variants, including MMR. We also suggest considering BC among the malignancies associated with LS.
Contribution of family history of gynecologic cancers to associated risk-factors and screening: Analysis of an Internet-based risk assessment tool.
Authors: O'Keefe Ryan M. , Lariviere Michael Joseph , Vachani Carolyn , Hampshire Margaret K. , Bach Christina , Arnold-Korzeniowski Karen , Healy Marisa , Metz James M. , Hill-Kayser Christine E. 
Published: May 2020

e13605 Background: Well-established risk-factors exist for gynecologic cancers (GC): estrogen exposure increases risk of endometrial cancer (EC); HPV infection and smoking are associated with cervical cancer (CC); oral contraceptive (OCP) use may be associated with an increased risk of CC but a reduced risk of EC and ovarian cancer (OC). Women with a family history (FH) of cancer are more likely to receive regular CC screening, but the association between FH of GC and other risk factors has not been investigated. Methods: Reduce My Risk is an Internet tool created in 2009 to provide personalized information regarding cancer risk, available at OncoLink.org. Voluntary participants were asked about risk factors and risk-associated behaviors. Differences between female respondents with v. without FH of GC were analyzed using chi-square test. Results: Among 16,878 female respondents, 841 (5.0%) had FH of CC, 345 (2.0%) EC, 1,117 (6.6%) OC, and 92 (0.5%) vulvar/vaginal (VC) cancer. Those with FH of any GC showed no difference in alcohol consumption compared to those without FH. Those with FH of CC, EC, OC, and VC were more likely to be obese (34.1% v. 24.7%; 37.2% v. 24.9%; 31.4% v. 24.7%, 43.7% v. 25%, p < 0.001 for all). Those with FH of CC were more likely to have first sexual intercourse before age 18 (69.2% v. 57.8%, p < 0.001) and to have > 10 sexual partners (24.0% v. 16.7%, p < 0.001). This group was also more likely to be current smokers (19.3% v. 11.7%, p < 0.001), and to smoke > 1 pack/day (6.5% v. 2.8%, p < 0.001). They were more likely to receive regular CC screening (91.2% v. 86.8%, p = 0.09), though the difference was not statistically significant. Women < 35 y with a FH of CC showed no differences in HPV vaccination rate (37.0% v. 39.3%, p = 0.29). Those with FH of EC were more likely to have menarche before age 12 (39.3% v. 32.0%, p = 0.005), and to have taken post-menopausal HRT for ≥2 y (77.6% vs. 66.8%, p < 0.001). Those with FH of EC, and OC were more likely to have taken OCPs (77.6% v. 66.8%; 71.9% v. 66.7%, p < 0.001 for both). Conclusions: Many with a FH of GC have increased likelihood of both modifiable and non-modifiable risk factors that are associated with the development of cancer. FH of CC did not increase likelihood of regular screening or HPV vaccination, but was associated with smoking, early intercourse, and multiple sexual partners. Future work should explore targeted intervention for those with FH of GC as a teachable opportunity for the benefits of weight reduction, smoking cessation, pap screening, and HPV vaccination.
Anaerobes in prostate cancer: New approaches to treatment and prevention.
Authors: Oliver Tim RTD , Bhudia Roshni , Chinegwundoh Frank , Wilks Mark 
Published: May 2020

e13606 Background: The sun-sensitive microaerophylic bacterium C. acnes, is linked with prostate cancer (PC) in 9 studies 3 of which are cohort studies of 289,043 men followed for 30 years from puberty. That circumcision reduces PC risk further supports a role for anaerobes as they are reduced on the circumcised glans penis. A 1988 study linked anaerobes with PC but considered them opportunists. Reports that H. pylori, linked to stomach cancer, is also a microaerophilic bacterium led us to reinvestigate the association of PC and anaerobes. Methods: The MOLDI-TOF methodology for analysing anaerobes in 18 post rectal exam urine samples has been previously reported ( https://www.nature.com/articles/s41598-017-13782-6 ). This report analyses outcome after a further 21 patients were recruited and follow up was extended from 1 month to a median of 43 months. In total there were 21 diagnosed as PC and 18 BPH. Results: Of the 29 anaerobic isolates, 19 were Chlostridiales family, 2 Prevotella and 7 Actinomycoses (includes C.acnes) family. 12 cases had obligate anaerobes, 7 microaerophylic bacteria and 20 none of these. In 27 patients with PSA > 1.5, 56% had anaerobes, while in 12 with PSA = < 1.5 it was 17% (p < 0.037 Fisher’s exact test) In the 21 with prostate cancer, 7 (64%) of 11 without anaerobes and 2 of 10 (20% ) with anaerobes remain on Active Surveillance (p = 0.08 Fisher’s exact test) vs in 18 without cancer, 10/11 (91%) without and 5/7 (71%) with anaerobes remain without the need of TURP intervention. Conclusions: This is a small study and needs expanding. Given the rising incidence of antibiotic resistance more resources should be focused on the immune deficiency associated with chronic bacterial infection. Expansion of technology used to produce bacterial vaccines to treat women with recurrent cystitis could offer new approaches to prevention of PC and to treat patients with raised PSA and negative biopsy. Modern approaches to immunotherapy against these bacteria with checkpoint inhibitors could be used in combination with androgen suppression and chemotherapy.
Is the incidence of breast cancer increasing? Using the NCDB and autoregressive integrated moving average models (ARIMA) to forecast breast cancer to 2030.
Authors: Elson Leah , Bilani Nadeem , Elimimian Elizabeth Blessing , Arteta-Bulos Rafael , Nahleh Zeina A. 
Published: May 2020

e13612 Background: The observed increase in the incidence rate of BC has been described due, in part, to higher, effective public health campaigns for screening, higher sensitivity among diagnostic testing modalities as well as an aging population. While the mortality rate associated with breast cancer has reported to fall by 1.8% every year since 2007, the disease burden itself has continued to grow and increased breast cancer rates will contribute to the strain already experienced within the United States healthcare system infrastructure. Therefore, the authors sought to use a large, national registry to develop a time series model that might help forecast the approximate breast cancer incidence rate, to the year 2030, as captured by the National Cancer Database (NCDB). Methods: In this time series forecast, autoregressive integrated moving average models (ARIMA) were constructed based on 2004-2016 historic breast cancer incidence rates, as reported by the NCDB. Multiple models were generated, using differing autoregressive parameters, and the most predictive model was chosen using the lowest Bayesian Information Criteria (BIC), and mean absolute percentage error (MAPE). Similar methodology has already been published to predict prostate cancer incidence. The best fit model was applied to forecast annual incidence in the NCDB to the year 2030. Statistics were performed using modeling systems in SPSS, version 26. Results: For this model, 12 years of NCDB breast cancer diagnoses were used, which included n = 1,924,425 cases, overall. Using ARIMA modeling, a best fit, stationary average was identified with autoregressive and difference terms of 1 (ARIMA (1,1,0), coefficient = 0.598; P = 0.028). Of the multiple models tested the model with the lowest BIC was chosen, with a MAPE of 4.71%. The best fit model forecasted n = 325,048 new breast cancer diagnoses to be captured annually by the NCDB, by 2030. Conclusions: In this analysis, the annual breast cancer incidence within the NCDB is predicted to increase by 21%, by 2030. This forecast, while slightly lower than previously reported by the National Cancer Institute, utilizes more recent historical data that reflects a period of leveling-off in disease incidence, during 2014-2016, as reported to the NCDB. This innovative model can be utilized to proactively plan public health strategies and allocate appropriate resources focused on reducing the burden of cancer.
Quantification of inequities in breast cancer incidence in New Mexico through Bayesian disease mapping.
Authors: Zahrieh David , Golafshar Michael A , Patel Samir H , DeWees Todd A 
Published: May 2020

e13617 Background: Breast cancer (BC) is the most prevalent cancer of women in the United States (US). The incidence rates for BC among American Indian and Alaska Native (AI/AN) women vary across the US. A novel application of Bayesian disease mapping was applied to quantify potential inequities in 10-year BC incidence in New Mexico (NM) in order to better inform health equity initiatives within the AI/AN at-risk population. Methods: Surveillance, Epidemiology, and End Results Program (SEER) data from 2005 to 2014 were used to identify new cases of BC within the 33 counties in NM. Initially, a Poisson-gamma model was applied to quantify the reduction in risk of BC within the at-risk AI/AN population compared with the general at-risk population. To account for spatial variation and to address the small area estimation problem inherent in these data by borrowing strength globally and locally in NM, we applied Bayesian disease mapping to the counts of county-level BC cases. We quantified the disparity effect, as measured by the rate ratio (95% credible interval [CI]), comparing the incidence of BC between at-risk AI/AN and non-AI/AN women, and assessed if the rate ratio differed between counties. Markov chain Monte Carlo sampling was used to estimate posterior quantities and the deviance information criterion was used for model selection. Results: In 2010, 1,041,758 women were at-risk for BC of which 107,656 (10.3%) were AI/AN women. During the 10-year study period, 12,974 new BC cases were recorded in the general at-risk population. In the at-risk AI/AN population, the expected number of new cases during the 10-year study period, therefore, was 1,340.74; however, 597 incidence cases of BC were diagnosed in the at-risk AI/AN population resulting in a posterior mean for the true relative risk of 0.445 (95% CI: 0.410, 0.482). Based on the selected model that accounted for over dispersion and spatial correlation among the 33 counties, the posterior mean of the overall adjusted rate ratio was 0.405 (95% CI: 0.336, 0.478). The adjusted rate of BC in AI/AN women was 0.40 times the corresponding adjusted rate for women who were non-AI/AN. Further, the adjusted rate ratios were similar for each county. Conclusions: The novel application of Bayesian disease mapping to these data provided substantial evidence of a significant overall disparity effect in BC incidence within NM between at-risk AI/AN and non-AI/AN women, which was more marked than previous reports. Targeted state-wide health equity initiatives may lead to reducing disparities in BC incidence in AI/AN at-risk women.
Clinical, sociodemographic, and pathological characteristics of breast cancer in the United States: A cross-sectional analysis from the National Cancer Database (NCDB).
Authors: Nahleh Zeina A. , Bilani Nadeem , Elson Leah , Elimimian Elizabeth Blessing , Zabor Emily Craig 
Published: May 2020

e13623 Background: Breast cancer (BC) remains the most commonly-diagnosed malignancy in women. BC encompasses great heterogeneity in patient pathologic and clinical characteristics, as well as treatment approaches and outcome by stage and subtype. This study aims to explore recent differences in characteristics and overall survival (OS) of BC across different facility types. Methods: We conducted a retrospective analysis of patients with BC, diagnosed between 2004-2016, based on the NCDB. Categorical variables were summarized using frequencies/percentages, whereas continuous variables were summarized using the median/interquartile range (IQR). OS was explored using the Kaplan-Meier method. Results: A total of 2,671,549 patients with BC were captured in this dataset. The median age at diagnosis was 61 (range 18-90 years). The majority n = 1,986,450 (75%) were non-Hispanic (NH) white; 286,176 (11%) were NH-black; 124,877 (4.7%) were Hispanic-white; 2,977 (0.1%) were Hispanic-black and 90,484 (6.1%) were Asian. The most common BC subtype was hormone receptor-positive (HR+)/HER2- (58%), followed by HR+/HER2+ (26%), HR-/HER2-negative (10%) and HR-/HER2+ (6.4%). 73% of cases were ductal; 15% lobular; the remaining histological subtypes included 0.9% epithelial-myoepithelial, 0.1% fibroepithelial, 0.4% metaplastic, < 0.1% mesenchymal, 1.6% rare breast carcinomas and 7% other carcinomas. The majority of patients received therapy at comprehensive community cancer programs (CPs) (45%), followed by academic/research CPs (30%), integrated network CPs (15%) and community CPs (9.5%). OS was best at academic (72% 10-year OS), followed by integrated network (69% 10-year OS), comprehensive community (68% 10-year OS) and community (63% 10-year OS) CPs. Significant differences in OS according to facility type remained when stratified by stage of disease (all p < 0.0001). OS was also significantly better for white (69% 10-year OS) versus black (63% 10-year OS) patients. Conclusions: This large database from the NCDB provides a comprehensive, recent overview of BC over the last 12 years. Facility type appears to be significantly associated with OS, such that academically designated centers have superior OS across all stages.
Impact of tuberculosis on mortality and healthcare resource utilization in cancer patients: A nationwide inpatient sample analysis.
Authors: Vohra Ishaan , Lingamaneni Prasanth , Katiyar Vatsala , Moturi Krishna Rekha , Malapati Sindhu Janarthanam , Singh Sunny R K , Gupta Shweta 
Published: May 2020

e13625 Background: Tuberculosis (TB) is a major public health concern. Patients with malignancy are at increased risk of developing TB as a result of depressed cellular immunity. The aim of the study is to analyze the prevalence, mortality and healthcare resource utilization of cancer patients with TB. Methods: Adult patients with malignancy and TB (cases) were identified using ICD10 code from Nationwide Inpatient Sample database 2017 and their data was compared to cancer patients without TB (controls). Univariate and multivariable logistic and Poisson regression models were used to analyze mortality and healthcare resource utilization. Results: Among 2,099,294 adult cancer patients admitted in 2017, 1115 were found to have TB. Majority (84%) had pulmonary TB. Mean age of patients was 60.3 years with 65% males and white predominance (33%). Overall prevalence of TB in cancer population was 51.3/100,000 patients, with highest being in Hodgkin lymphoma (182.6/100,000) followed by and MDS/ MPN patients (113.2/100,000) (p < 0.01). Among solid organ malignancies, lung cancer had the highest prevalence of TB (92.1/100,000). After adjusting for the demographic and patient related variables, TB was found to be an independent risk factor for mortality in cancer patients (adjusted HR 1.7, 95% CI 1.13-2.66, p = 0.017). The mortality of cases during inpatient stay was 10.2% compared to 6.2% in controls. The mean length of stay for cases was 12.4 days vs 6.3 days in controls (adjusted coef +6.12, 95% CI 3.64-8.59, P < 0.001) and mean hospital charges in cases was $136,026 vs $67,381 in controls (adjusted coef 68,680, 95% CI 39,053.5-98,306.9, p < 0.001). On multivariate analysis, predictors of mortality in cancer patients with TB were older age, malnutrition, uninsured status, higher Charlson comorbidity score ( = > 3), ICU care, venous thrombo-embolism and Acute renal failure requiring dialysis. Conclusions: TB significantly increases the morbidity and mortality in cancer patients. Widespread TB screening, prompt recognition of infection and treatment can considerably reduce health care costs. [Table: see text]
Reproductive risk factor patterns in the Caribbean affecting breast cancer age of onset.
Authors: Sanchez-Covarrubias Alex , Cerbon Danielle , Barreto Coelho Priscila , Donenberg Talia , Akbari Mohammad R , Ali Jameel , Butler Raleigh , Curling Duvaughn , Dodds Leah , DeGennaro Vincent A. , Dyer Hedda , Halliday Darron Andrew Calvin , Narod Steven , Reis Isildinha N , Schlumbrecht Matthew , Turnquest Theodore A. , Wharfe Gillian , Hurley Judith , George Sophia 
Published: May 2020

e13632 Background: Breast cancer is the leading cause of cancer in high-income (HIC) and low to middle-income countries (LMIC); and is the most common diagnosed cancer among women. Factors affecting breast cancer incidence include obesity, parity, age of menarche, age of first pregnancy and mutations in BRCA1/2 and genes involved in the homologous recombination repair pathway. These factors differ between HICs and LMICs including countries in the Caribbean. The majority of women from the Caribbean are of African ancestry and Black women have increased morbidity and mortality rates of breast cancer. Our goal is to study how reproductive patterns affect breast cancer age at presentation in Caribbean-born women. Methods: We conducted a prospective observational study recruiting patients from The Bahamas, Barbados, Cayman Islands, Dominica, Haiti, Jamaica and Trinidad and Tobago. Women were considered eligible if they were diagnosed with primary breast cancer at any age. The cohort was divided into four groups based on the year of birth ( < 1950, 1950 – 1959, 1960 – 1969, > 1970). The following data was collected: age at diagnosis of breast cancer, family history of cancer, age of first pregnancy, number of pregnancies, number of children, number of siblings, BMI at time of enrollment, age of menarche and menopause. Data analysis was conducted using the Chi-square test, ANOVA and logistic regression model. Results: A total of 1015 were enrolled and 995 met inclusion criteria. When comparing women born < 1950 to those > 1970, there was a statistically significant difference between means for the variables: Age at Breast cancer diagnosis (60.7 vs 35, p <.0001); number of siblings (4.5 vs 6.6, p <.0001); age of menarche (13.4 vs 12.3, p <.0001); number of pregnancies (4 vs 2.09); number of children (3.5 vs 1.6, p <.0001) and age of menopause at diagnosis (47.4 vs 37.5, p <.0001). When comparing women who were never pregnant to those who experienced pregnancy, mean age at breast cancer diagnosis was significantly reduced from 47.3 to 41.5 (p < 0.0001). Women who had n = 3 or more children were diagnosed older (mean of 49.9 years), compared to women with 2 or less children, (45.1 years, p < 0.0001). In multivariate analysis a higher likelihood for a positive mutation between year of birth 1960-1969 (aOR 2.19 [1.24 – 3.88], p = 0.007) and > 1970 (aOR 2.02 [1.06 – 3.88], p = 0.034) compared to < 1950. Conclusions: Our data shows that the Caribbean has undergone a rapid change in reproductive patterns in one generation. These changes provide an insight of risk factor patterns for breast cancer incidence which are associated with younger age of onset.