bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of chronic hepatitis C virus infection with an increased risk of lung cancer: A systematic review and meta-analysis.
Authors: Ponvilawan Ben , Charoenngam Nipith , Rujirachun Pongprueth , Wattanachayakul Phuuwadith , Tornsatitkul Surapa , Rittiphairoj Thanitsara , Ungprasert Patompong 
Published: May 2020

e13562 Background: Chronic hepatitis C virus (HCV) infection is associated with increased risk of multiple types of extrahepatic cancer, such as lymphomas, thyroid cancer and renal cancer. However, whether HCV infection also increases the risk of lung cancer is still inconclusive. This systematic review and meta-analysis was performed in order to determine the relationship between chronic HCV infection and lung cancer. Methods: A systematic review was performed using EMBASE and MEDLINE databases from inception to November 2019 with search strategy that represents “hepatitis C virus” and “cancer”. Eligible studies must be cohort studies which include patients with chronic HCV infection and comparators without HCV infection, then follow them for incident lung cancer. Relative risk, incidence rate ratio (IRR), standardized incidence ratio, or hazard risk ratio of this association along with associated 95% confidence interval (CI) from each study were extracted and combined for the calculation of the pooled effect estimate using the random effect, generic inverse variance. Results: 20,459 articles were discovered using the aforementioned search strategy. After two rounds of review, eight studies fulfilled the inclusion criteria and were included into the meta-analysis. Chronic HCV infection was significantly associated with increased risk of lung cancer with the pooled relative risk of 1.94 (95% CI, 1.56 – 2.42; I2 = 87%). Funnel plot was fairly symmetric and not suggestive of presence of publication bias. Conclusions: Chronic HCV infection is significantly associated with a 1.94-fold increased risk in the development of lung cancer compared to no infection.
The role of HPV vaccination as a cancer prevention agent.
Authors: Mullai N , Osman Soleiman , Rattenni Joseph 
Published: May 2020

e13566 Background: Human papilloma virus (HPV) is the most common sexually transmitted agent and has extensive association with many malignancies such as cervical, vaginal, vulvar, penile, and head and neck cancers. Vaccination helps prevent sexually transmitted diseases due to HPV. In addition, it provides protection against cancers caused by persistent, high-risk HPV infection in both male and female. Methods: Data collected from the medical records of patients diagnosed with anogenital, and head and neck cancers during 2017-2019 were studied retrospectively and the association of HPV infection was analyzed. Results: There were thirty-three cases of anogenital, and head and neck cancers diagnosed during the study period. The following were the occurrences: penile cancer 1, anal cancer 4, cervical/uterine/vaginal cancers 10, and head and neck cancer including tonsil, base of tongue, vocal cord, and glottis 18. HPV status was available in twenty-six (79%) patients. Fourteen patients were positive for high-risk 16/18 HPV strain, twelve were HPV negative, and HPV status was unknown for seven patients. Most of the patients were smokers and none of them had received HPV vaccination. The patients were treated appropriately with chemotherapy, radiation, and surgery. Conclusions: Human papilloma virus (HPV) infection type 16/18 is the most common sexually transmitted infection associated with significant anogenital and head and neck cancers.Vaccinations protect against persistent, high-risk HPV infection that may lead to malignancies. However, the HPV vaccination initiation and completion rates are only 41.7% and 21.6% respectively in males, and 60% and 39.7% respectively in females. The lack of opportunity does not appear to be a major reason for this low coverage. Some of the barriers for low adoption of HPV vaccination were concern about vaccine safety (70%), lack of knowledge about HPV related diseases (56%), very young to vaccinate (56%), fear of riskier sexual behavior (56%), and reluctance as not being included in the required immunization schedule (71%). In addition, several people refused HPV vaccination due to misinformation in social media. The primary purpose of HPV vaccination is to help prevent sexually transmitted diseases. Further, such vaccination can also prevent several cancers caused by persistent infection. Therefore, HPV vaccination has the potential to eliminate such risk if enforced at a young age in school. The above study and data stress this role and the importance of public awareness of the HPV vaccine as a cancer prevention agent.
Lung cancer incidence in never smokers in the Southeast of Brazil: 10 years analysis.
Authors: Pulido Jose Zago , Aleixo Sabina B. , Parmanhane Narelle 
Published: May 2020

e13571 Background: Lung cancer is a leading cause of cancer death worldwide. In Brazil, the Ministry of Health estimated an absolute incidence of 30,200 cases of lung cancer in 2020. Eighty-five percent of diagnosed cases are associated with consumption of tobacco products. Although smoking remains the predominant cause, lung cancer in never smokers is an increasingly prominent public health problem. However, data on this topic, particularly lung cancer incidence rates in developing countries in never smokers are limited. Methods: The data presented in this work correspond to the period from 2007 to 2017 and were extracted from the database of the Hospital Cancer Registry of the Evangelical Hospital of Cachoeiro de Itapemirim (RHC / HECI) through SisRHC, a computerized database management tool for Hospital Cancer Records. Results: Of the 494 patients who were diagnosed with lung cancer aged 18 years or over, 395 (80%) had complete information on a history of tobacco use, of which 68 patients denied smoking. Based on data from 68 patients, the years 2011 and 2012 had the lowest incidence, 6%, of non-smokers with lung cancer. 2009 and 2007 were the years with the highest incidence, 24 and 33% respectively. In the remaining years, the percentage varied between 15 and 23%. Regarding gender, 47 (69%) of the cases were women and 21 (31%) were men. Adenocarcinoma without a specific origin (NOS) was the most frequent histological type in non-smoking patients, with 33 (48.5%) of the cases, followed by malignant neoplasia 10 (14.7%), squamous cell carcinoma NOS 8 (11, 8%) and NOS carcinoma 7 (10.3%), the types of NOS large cell carcinoma, NOS small cell carcinoma, NOS papillary carcinoma, NOS bronchioloalveolar adenocarcinoma and adenosquamous carcinoma account for 10 (14.7%) cases. Analyzing the clinical staging (CE) at the time of diagnosis, 1 (1.5%) had EC 1, 4 (5.9%) EC 2, 12 (17.6%) EC 3, 42 (61.8%) EC 4 and 9 (13.2%) had no reports of staging. The median incidence rate was 17%, confirming that smoking remains the biggest cause of lung cancer, and reinforcing the need for more comprehensive epidemiological analyzes for this population. As the data can reach even higher percentages, as the information is provided by patients, without an available reliability assessment method. Conclusions: Lung cancer in never smokers is a major public health problem and further exploration of its patterns of incidence, etiology and biology is needed.
Highlights of BRCA genetic testing in prostate cancer from a real-world patient cohort in Australia.
Authors: Tinton Inga , Spence Lara , Henry David H. 
Published: May 2020

e13574 Background: There is an increase in interest and awareness in BRCA 1/2 testing recently. However, despite high awareness of these tests due to their frequent use among patients with certain cancer types such as ovarian cancer or breast cancer, BRCA testing is still only emerging in the prostate cancer (PC) treatment landscape. This study aims to understand what is driving the interest and use of BRCA testing in PC as well as the main barriers to testing in Australia. Methods: Between September 2019 and November 2019, n = 51 physicians of different specialties (n = 26 medical oncologists, n = 11 urologists, n = 14 pathologists) in Australia provided their quantitative and qualitative insights on BRCA testing. Medical oncologists and urologists (n = 37) also submitted patient tissue record forms of PC patients (n = 102) who received at least one biomarker test. The findings are derived from perceptual questionnaires, patient tissue record forms, and qualitative interviews. Results: The data suggests high (100%) awareness of BRCA testing in PC among medical oncologists and urologists, however that’s not the case among pathologists (36%). BRCA testing was seen in almost half of the patient records collected, primarily as blood tests (40%) as opposed to tissue (28%) or any other tests. Larger number (40%) of blood tests are carried out post-diagnosis with almost half (46%) of them initiated due to family history. Prior treatment history and patient request are more common patient selection criteria when deciding whether to test any PC patient for BRCA. The main barrier (64%) to BRCA testing is lack of funding/reimbursement for the test in PC at the moment. Only clinical trial PC patients typically have access to funded BRCA tests or those patients who are supported by the genetic counsellor program. Conclusions: Driven by significant uptake in ovarian and breast cancer and high awareness among oncologists and urologists, BRCA testing for prostate cancer is being increasingly used in the clinical setting in Australia. However, significant barriers remain; addressing these barriers should result in further uptake.
Molecular testing patterns and implications for treatment at a cancer center.
Authors: Lam Clarissa , Mallen Adrianne Rose , Walko Christine Marie , Chern Jing-Yi 
Published: May 2020

e13576 Background: Genetic testing has revolutionized the care of ovarian cancer, providing a potential for targeted therapies and cancer prevention through cascade testing. Previous historical control for genetic testing rate of 28.5% at our institution, this initiated a multilevel intervention to improve guideline concordant care. The main objective of this study is a descriptive analysis of genetic testing patterns with the implementation of a genetics tumor board (GTB) at an NCI comprehensive cancer center (CCC). Methods: All gynecologic oncology cancer patients who underwent somatic testing from 3/2019 to 1/2020 were included in gynecologic oncology GTB. A descriptive analysis was performed on the ovarian cancer patients. Information regarding patient demographics, cancer characteristics, treatment, and follow-up were obtained from the medical records. Results: There were a total of 81 patients included in GTB during this time period. Fifty-four of 81 (66.7%) received care at our CCC and 27 of 81 (33.3%) were seen as a second opinion case. The patients included in GTB were comprised of recurrent ovarian cancer cases and newly diagnosed ovarian cancer cases. Of the patients included in genetics tumor board, 58 of 81 (71.6%) of patients received both germline and somatic testing. Genetics referrals were placed for 16 of 23 (69%) of the patients who received somatic testing without subsequent germline testing. Twelve of 81 (14.8%) GTB patients were identified for clinical trials during this time period. Conclusions: Genetic testing has become a cornerstone to ovarian cancer care. Implementation of a genetics tumor board at our institution has increased rates of germline testing compared to historical controls. With genetic tumor board being made up of a third of patients seeking a second opinion, we are able to provide comprehensive care to such patients in the form of genetic counseling referrals and clinical trial opportunities. Genetics tumor board also appears to highlight the cohort of patients with the most aggressive cancers: high-grade, advanced stage, and high rates of recurrence. This can potentially improve care by providing an arena for a multidisciplinary discussion of our most complex patients. Ongoing studies with the implementation of our cancer pathways may help determine which modifiable factors can be targeted to help increase adherence to genetic testing recommendations as we continue to strive for guideline-based care.
Cancer incidence in Behçet's Disease.
Authors: Guven Deniz Can , Bolek Ertugrul Cagri , Altintop Sabri Engin , Celikten Burcu , Aktas Burak Yasin , Kiraz Sedat , Gullu Ibrahim Halil , Karadag Omer , Dizdar Omer 
Published: May 2020

e13583 Background: Previous studies demonstrated increased risk of cancer in systemic autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus (SLE) and sjögren syndrome due to uncontrolled inflammation. Behçet’s disease (BD) was also reported to be associated with an increased risk of cancer, although data is limited and differences in study designs was an important issue. In this study, we aimed to assess cancer incidence in a large cohort of BD patients and to compare with the data of the Turkish National Cancer Registry (TNCR) in the same age and gender groups. Methods: The study cohort consisted of BD patients of > 18 years old age and without a prior cancer diagnosis who were prospectively recorded in Hacettepe University Vasculitis Center. Data on any cancer was collected from the patient files. Cancer incidence was compared with age- and gender-specific cancer incidence rates of the normal population retrieved from the 2014 Turkish National Cancer Registry (TNCR) data using standardized incidence rates (SIR). Results: Totally 451 adult cases with BD were included in the study. The median age of the cohort was 43 (20-75) and 52.5% of the patients were males. Eleven cancer cases were observed during a median 124 months follow up. Behçet’s Disease was associated with an increase in cancer risk compared to expected counts in the corresponding age and sex group (SIR 2.84, 95% CI 1.50-4.94, p < 0.001). Cancer risk was particularly increased in men (SIR: 5.63, 95% CI: 2.62–10.70, p < 0.001) compared to TNCR data. Patients with papulopustular lesions had a trend towards a decreased risk of cancer (p = 0.060) and patients using azathioprine had a significantly decreased cancer risk (p = 0.031). Conclusions: This study revealed the cancer risk of patients BD was increased approximately three times compared to corresponding age and sex group. Besides the routine care, increased attention for cancer surveillance is required in the follow-up of BD patients.
A retrospective chart review evaluating the relationship between cancer diagnosis and drinking water source on the Lower Eastern Shore of Maryland.
Authors: DeRidder Angela Marie , Kalluri Sowjanya , Holdai Veera 
Published: May 2020

e13587 Background: The lower Eastern Shore of Maryland is an agricultural and rural region with high cancer rates. The purpose of this retrospective study was to determine if cancer patients on the lower Eastern Shore utilize higher rates of well water compared to individuals in the general county population. Methods: A retrospective chart review of all cases of colon, lung, melanoma and breast cancer diagnosed at Peninsula Regional Medical Center in 2017 was completed. Demographic and clinical information including family, smoking and prior cancer history, as well as residential water source were recorded. Individuals with residential addresses outside of Wicomico, Worcester and Somerset counties were excluded. Overall well water use for each county was determined using U.S. 2010 census data. Fisher’s exact test was used to compare well water utilization rates in cancer patients and the overall county population. Results: 631 patient cases were reviewed and 384 patients were identified for data analysis. The majority of patients were white (81%), diagnosed with breast cancer (41%), and used well water (52%, n = 209). Cancer patients in the three counties combined were significantly more likely to use well water than individuals in the general county population (OR = 2.5, 95% CI 2.11, 3.16). In Wicomico county, 61% of cancer patients used well water (n = 140). Wicomico cancer patients were more likely to use well water than individuals in the general Wicomico county population (OR = 4.4, 95% CI 3.41, 5.78). No significant findings were observed for patients living in Worcester and Somerset counties. No differences in family, smoking or prior cancer history in patients using well water versus municipal water were identified. Conclusions: Cancer patients on the lower Eastern Shore of Maryland used well water more than municipal water. Cancer patients also utilized higher rates of well water compared to individuals in the general county population. Interpretation is limited by small sample size and lack of causality, however the results signal a need for additional studies evaluating well water use and cancer risk in this region.
Association of tumor mutational burden with age in solid tumors.
Authors: Yu Zhuang , Wang Jing , Feng Lingxin , Yang Xue , Qi Qi , Li Wenqi , Zhang Xing , Ge Minhui , Qin Huijuan 
Published: May 2020

e13590 Background: Immunotherapy is becoming one of the promising treatments for cancer administration, and several studies indicated a better outcome was received in patients with high tumor mutation burden (TMB). The distribution of TMB is still unknown and this study aimed to analysis the association between TMB and age especially in East Asian populations. Methods: In our study, TMB value was measured as the numbers of synonymous, nonsynonymous mutations and InDels by next generation sequencing with 539 genes panel in tumor tissue. TMB-H was defined as highest mutation load quintile (top 20%) in each cancer type. The association between TMB and age in 874 patients was investigated including 174 patients with liver cancer, 32 patients with bile duct cancer, 54 patients with gastric cancer, 119 patients with colorectal cancer, 27 patients with pancreatic cancer, 32 patients with melanoma, 25 patients with glioma and 411 patients with lung cancer cases, respectively. Spearman rank correlation analysis, Mann-Whitney U-test and Fisher’s exact test were used for statistical analysis. Results: A significant correlation between TMB and ages was observed in patients with solid tumors (r = 0.204, p = 1.263×10−9). The median age of included patients was 60 years-old. Based on nonparametric test, the value of TMB in patients with liver cancer ( p = 2.310×10−4), gastric cancer ( p = 0.029) and lung cancer ( p = 0.001) aged ≥ 60 years-old was significantly higher than the corresponding patients aged < 60 years-old. No significant differences of TMB values were found between patients < 60 and ≥ 60 years-old in bile duct cancer ( p = 0.419), colorectal cancer ( p = 0.075), pancreatic cancer ( p = 1), melanoma ( p = 0.952) and glioma ( p = 0.720). The TMB-H ratio in patients with liver ( p = 0.049) and gastric ( p = 0.015) cancer aged < 60 years old was significantly lower than patients aged ≥ 60 years-old. Conclusions: Our study indicated the TMB value and TMB-H ratio were relatively higher with ages ≥ 60 years old in specific tumors, which might provide useful information to guide precisely the the application of PD-1 or PD-L1 inhibitors. As a retrospective study with a relatively small population, the conclusions of this study needed to be verified with a larger sample.
Impact of socioeconomic status on the incidence and mortality of multiple myeloma in the United States.
Authors: Omore Ibrahim , Sheppard Richard Stephen , Beale Stefani 
Published: May 2020

e13595 Background: Socioeconomic deprivation is known to be associated with poorer survival among cancer patients, but studies has not shown the impacts of socioeconomic status on the Incidence and mortality of multiple myeloma. This article analyzed the socioeconomic inequalities in United States Multiple Myeloma Incidence and Mortality. Methods: We examined national trends in the Incidence and Survival disparities among patients with Multiple Myeloma by race/ethnicity and socioeconomic status. A retrospective cohort of Multiple Myeloma patients diagnosed from 2012 to 2016 belonging to all age groups, genders, income per household and level of education was identified from Surveillance, Epidemiology and End results database, United States Cancer Statistics and Population data from Census Bureau. Results: We found mortality to be higher among African American and in States with low median household income and low level of education. In conclusion our study shows a strong correlation between social deprivation and decreased survival in patients with Multiple Myeloma in all age groups. Also we found that Asians and Pacific Islanders seems to have higher survival compare to African Americans and Other ethnicities. Conclusions: Census‐based socioeconomic measures such as poverty and education levels could serve as important surveillance tools for monitoring trends in cancer‐related health inequalities and targeting interventions.
Former smokers as the most frequent smoking status in patients with lung cancer in Brazil.
Authors: Costa Guilherme Jorge , Mello Maria Julia Gonçalves , Ferreira Carlos Gil , Bergmann Anke , Thuler Luiz Claudio Santos 
Published: May 2020

e13597 Background: Lung cancer is the principal cause of death from cancer worldwide. However, little is known of the clinic and histological profile from former smokers patients with lung cancer. Objectives: To characterize the clinical and histological profile and to identify independent factors associated with smoking status (former versus current) in patients with lung cancer in Brazil between 2010 and 2016. Methods: An ecological study was conducted using data from Brazilian hospital-based cancer registries between 2010 and 2016. Data with p-value < 0.20 in the univariate analysis were included in the logistic regression analysis by using the stepwise forward method, in order to control for potential confounders. Results: This study evaluated 23,462 patients with lung cancer diagnosed between 2010 and 2016 in Brazil. In general, the average age of all patients was 63.7 + 10.7 years old. Never smokers, former smokers and current smokers corresponded to 18.9 %, 35.2% and 45.9% of cases in the moment of the diagnosis, respectively. Current smokers were the most frequent smoking status, albeit its frequency decreased significantly during the period. Male and female former smokers had its frequency increasing over the period and male former smokers became more frequent than males current smokers since 2015. In multivariate analysis, comparing former versus smokers, the follow variables were statistically significant: former drinkers, older age group, higher schooling, married or living married, from non-public (private) health system insurance, living in region North, Northeast and West Center and more recent year of diagnosis. Conclusions: Recently, former smokers with lung cancer is increasing and became the most frequent smoking status, as a result of the very effective policies against to smoking in Brazil since 1990’s. The increase in that specific population discloses some interesting challenges and opportunities in clinical and translational settings.