bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of advances in management of uterine-serous-carcinoma on population mortality.
Authors: Wang Aifen , Hou Shunyu , Feng Ninghan , Hu Weidong , Zhang Yayun , Xu Jiaqi 
Published: June 2024

e22516 Background: Incidence and mortality of uterine cancer has reported to be declining. However, mortality trends of endometrial serous carcinoma remain unclear at a population level. Methods: We applied SEER to evaluate uterine-serous- carcinoma mortality and relevant deaths of this disease to incident cases. We assessed trends of population mortality based on specific causes and races. Incidence of uterine serous carcinoma were evaluated based on ethics and calendar year. Trends of incidence and incidence-based mortality were evaluated by Joinpoint software. Results: Incidence of uterine serous carcinoma decreased by 1.51% from 2000 through 2017, followed by increase of 16.58% from 2017 through 2019. Mortality of women with uterine serous carcinoma due to uterine serous carcinoma decreased by 4.33% annually from 2000 to 2010, and then decreased at a rate of 1.88% every year from 2010 to 2017, and then sharply declined by 44.69% from 2017 to 2019. Mortality of women with uterine serous carcinoma due to other causes increased by 0.94% annually from 2000 to 2016, and then increased at a high rate of 35.18% every year from 2016 to 2019. Incidence-based mortality of women with uterine serous carcinoma due to other causes increased by 39.03% annually from 2000 to 2004, and then increased at a rate of 2.93% every year from 2004 to 2019. Incidence-based mortality of patients due to other causes showed similar pattern. Patients’ incidence-based mortality due to uterine serous cancer increased at rates of 111.02% and 9.80% annually from 2000 through 2002, from 2002 through 2006 respectively, followed by a decrease of 3.87% annually from 2006 through 2019, and then a gradual increase of 6.55% annually from 2002 through 2005. Incidence of white patients with uterine serous cancer decreased at a rate of 4.42% from 2000 through 2017 and then increased by 21.61% from 2017 through 2019. Incidence of Asians patients presented similar pattern. However, incidence of Black patients increased at a rate of 0.93% from 2000 through 2015 and then sharply increased by 8.49%. Incidence-based mortality of white patients with uterine serous cancer increased at a rate of 105.16% from 2000 through 2002, and then increased by 10.93% from 2002 through 2006, followed by a decrease of 3.40% from 2006 through 2019. Incidence-based mortality of Black patients elevated at a rate of 114.03% from 2000 through 2002, and flatten out, increased by 1.94% from 2002 through 2019. Incidence-based mortality of Asian patients showed similar pattern. Conclusions: Declined incidence-based mortality from 2006 through 2019 may associate with management advances of uterine serous carcinoma. Decreased incidence-based mortality of White patients with uterine serous carcinoma from 2006 through 2019 and increased incidence-based mortality of Black patients and Asian patients with uterine serous carcinoma in same period may related to better management resource of White patients.
Patterns and trends in incidence, survival, and treatment among patients with early-onset lung cancer in the U.S.: A population-based study.
Authors: Li Wang-Zhong , Liang Hengrui , Liu Jun , Wang Wei , Huang Ying , Lao Shen , He Miao , Liang Wenhua , He Jianxing 
Published: June 2024

e22517 Background: Lung cancer is the second leading cause of cancer-related deaths among young adults. An in-depth investigation into the demographic distribution and temporal trends in early-onset lung cancer (EOLC) incidence and survival, as well as treatment patterns, could help monitor the cancer burden, identify high-risk populations, and develop effective screening and prevention strategies. Methods: This serial cross-sectional study used data from the U.S. Cancer Statistics (USCS) and the Surveillance, Epidemiology, and End Results (SEER) program. EOLC refers to lung cancer diagnosed in individuals aged 20-49 years. USCS database (2001-2019) was used for demographic description and incidence estimation. SEER-17 registries database (2000-2019) was used for survival estimation and treatment patterns examination. Age-adjusted incidence rate per 100,000 population and cancer-specific survival were reported. Changes in rates were assessed with average annual percentage change (AAPC) using Joinpoint regression. Results: There were 4,086,435 lung cancer cases recorded between 2001 and 2019 in the U.S. (USCS: 53.3% male; median age of 70 years). EOLC accounted for 4.1% (169,132) of all lung cancer cases and was more common among females, non-Whites, with higher adenocarcinoma and advanced-stage diagnoses. During this period, the incidence of EOLC decreased from 9.0 to 4.5 per 100,000 population (APC, -4.2; P < 0.001). EOLC incidence continued to decrease across all demographic groups, except for young people aged 20-29. The rate of decline was faster among men than women, blacks than whites, squamous carcinoma than adenocarcinoma, and distant disease than localized disease. The historical higher incidence among young men vs. young women and among blacks vs. whites have been reversed in recent years. A consistent increase in survival rates of EOLC across all demographic groups from 2001 to 2017 (SEER-17) was observed. Despite the increases were more pronounced among men than women and among black individuals than white individuals, gender and racial disparities persisted. EOLC patients received more intensive treatment than late-onset patients. Still, 12.1% of EOLC cases were not treated, and this was most common among black individuals and those with distant disease. Treatment patterns for EOLC have not undergone significant changes in recent decades. Of note, the proportion of untreated patients has not decreased during the study period. Conclusions: EOLC was an uncommon type of disease with distinctive clinical features in the U.S. Substantial decreases in incidence and improves in survival were observed, whereas major treatment pattern remained relatively stable.
Examining the epidemiology of AIDS-defining and HPV-associated cancers in HIV endemic areas of south Florida for development of targeted intervention.
Authors: Leavitt Antonia Pryor , Lee Ming , Nahodyl Lauren , Krenz Till , Kobetz Erin N. 
Published: June 2024

e22522 Background: The Miami-Dade and Broward Counties in South Florida (SF) have the highest incidence of HIV infection in the United States, with over 47,000 people living with HIV as of 2021. The epidemiology and burden of cancers associated with HIV in SF have not been fully described, hampering efforts for effective cancer control. This study examines the regional epidemiology of AIDS-defining cancers and HPV-associated cancers, for which HIV+ patients face higher risk. The results are used to develop education and community screening events targeting communities with high incidences of these cancers. Methods: The catchment area of Sylvester Comprehensive Cancer Center, consisting of Miami-Dade, Broward, Palm Beach, and Monroe Counties for a total population of six million was studied. Using the 2015-2019 data from Florida’s official cancer registry, age-adjusted incidences (AAI) for AIDS-defining cancers and HPV-associated cancers were calculated for all census tracts in SF. Geospatial hot spot analysis was then applied to identify statistically significant clusters (hot spots) of census tracts with high AAI of these cancers. Results: We identified two clusters of hot spots for AIDS-defining and HPV-associated cancers in SF. Except for penile cancer in one cluster, both clusters have HPV-associated cancer incidences that are significantly higher than the state averages. Specifically, one cluster has the highest incidence of anal cancer in SF, while the other has a notable concentration of penile cancer. Conclusions: Using the results, we have developed targeted educational and screening events for communities within the hot spots. A screening summit was recently held in a hot spot community where several screening and educational events were offered on a single day. By sharing information about the epidemiology of these cancers, we were able to facilitate community buy-in and develop working relationships with community partners to provide culturally competent and targeted intervention for a population who are less likely to undergo screening. [Table: see text]
Prevalence of HTLV-1 and 2 infection in the blood donor population of Colombia during 2012 to 2022.
Authors: Molina Jaime , Triana Ivan Camilo , Segovia Javier 
Published: June 2024

e22528 Background: The HTLV-1 and 2 virus are oncogenic retrovirus with a global distribution. Viral infection is primarily associated with two conditions: HTLV-1-associated myelopathy and adult T-cell lymphoma. Although Colombia is an endemic country for the virus, data on its incidence, prevalence, and the population characterization of infected individuals are limited. Methods: This is a descriptive observational study of a retrospective cohort from a blood donor population of Fundación Hematológica de Colombia from 2012 to 2022, to determine the seroprevalence of HTLV-1 and 2 in this population. Demographic and clinical variables such as age and gender were described to characterize the seropositive population and identify specific populations, such as women of childbearing age who are seropositive for the virus. Results: During the study 1,553,478 patients were recruited, of which 3,484 were seropositive, representing a global prevalence of 0.22% over 10 years. The annual incidences were as follows: from 2012 to 2013, 0.22%; from 2014 to 2015, 0.26%; 2016 to 2017, 0.23%; 2018 to 2019, 0.25%; 2020 to 2021, 0.15%; and in 2022, 0.12%. Among the seropositive individuals, 58% were women, and 42% were men. In the donor population studied, the order of prevalences by city was as follows: Bogotá with 48%, Ibagué 13%, Barranquilla 7%, Pasto 5%, Villavicencio 4%, Pereira 3%, Soacha 3%, Tunja 2%. The average age for seropositive women and men was 22 years. 54% of seropositive women were within the reproductive age. Conclusions: Our cohort has a higher seroprevalence compared to North America. In Colombia, the two cities with the highest prevalence are the capital of the country and the city of Ibagué in our study. From a public health perspective, it is noteworthy that approximately 1100 seropositive women for HTLV-1 and 2 are in reproductive age and could potentially transmit the oncogenic virus through vertical transmission or breastfeeding. With our results it would be in the interest of public health agencies to report positive results to women of child bearing age and positive donors to begin health counseling as soon as possible.
Knowledge, attitudes, and practices of university students towards risk factors, screening, and perceived barriers of screening regarding colorectal cancer: A multi-country study from the eastern Mediterranean region.
Authors: Tarhini Zeinab , Christou Niki , Jost Jeremy 
Published: June 2024

e22543 Background: Colorectal cancer (CRC) tends to be diagnosed at a younger age and at a more advanced stage. Knowledge and awareness of CRC and its screening in Middle East are suboptimal, and most countries lack national screening programs. Our objective was to assess the knowledge, attitudes and practices of university students regarding risk factors, screening and perceived barriers to CRC screening in Middle Eastern countries. Methods: A cross-sectional study using a convenience sampling method was done in different universities across ten Middle Eastern countries: Lebanon, Iraq, Syria, Palestine, Egypt, Jordan, Saudi Arabia (KSA), and others (Qatar, United Arab Emirates, Kuwait). Data were collected using a questionnaire shared with students in various universities. It comprised five main sections: socio-demographic characteristics, CRC knowledge, risk factors, symptoms and screening, attitudes, practices and barriers related to CRC screening. The questionnaire developed on the basis of a literature review, was properly translated and validated using factorial and reliability analysis. Results: A total of 4597 students participated in the study with a mean age of 24.28 ± 7.62 years. Participants’ countries of residence were Lebanon 1107 (24.1%), Jordan 811 (17.6%), Iraq 769 (16.7%), Palestine 478 (10.4%), Syria 450 (9.8%), Saudi-Arabia 438 (9.5%), Egypt 499 (10.9%) and others 45 (1.0%). Most participants had heard about CRC (87%). 2491 (54.2%) had first or second -degree relatives diagnosed with cancer. 84.2% of participants intend to undergo CRC screening in the future, however, 25.1% wouldn't pay for the screening if it is not covered by health insurance. The majority of students demonstrated good knowledge of CRC (96.5%), with Egypt demonstrating the highest level (98.2%), followed by Lebanon (97.1%) and Iraq (97.1%), and Jordan the lowest (94%). Factors associated with good knowledge were age (aOR = 1.03; 95%CI: 1.00-1.05), health-related studies (aOR = 2.80; 95%CI = 2.00-3.93), and the participant’s country of residence. The most important barrier to CRC screening in Lebanon was the lack of financial resources with high cost of test (52.6%), lack of health insurance in Syria and Jordan (50.4% and 49.3% respectively), poor counseling from doctors in KSA (52%), and the inadequacy of awareness campaigns in Iraq (57.1%), Egypt (56.1%) and Palestine (55%). Conclusions: Students in the Middle East demonstrate good knowledge of CRC. Nevertheless, they perceive barriers to CRC screening, including limited financial resources, high cost of tests not covered by health insurance, and inadequate awareness campaigns.
Leveraging real-world data from multiple institutions to assess the rate of bilateral mastectomy after cancer genetics evaluations with genetic counselors.
Authors: Daley Ashley , Russell Callan , Stuhlmiller Timothy Joseph , Kaufman Zachary , Davies Jill , Caleshu Colleen 
Published: June 2024

e22551 Background: Genetic counselors (GCs) assess patients’ risk of cancer and counsel them on cancer screening and preventative measures, based on national guidelines. Prior studies have found that adherence to guideline-based care is higher after genetic counseling. Thus care provided by GCs leads to a variety of imaging and surgical services that can both improve patient outcomes and generate revenue for health systems, which can in turn help financially support cancer genetics programs. Research that quantifies such downstream services and revenue is lacking. We aimed to address this gap by using real-world data from multiple institutions to quantify the rate of bilateral mastectomies occurring after cancer genetics evaluations performed by GCs. Methods: We studied consecutive patients from a nationwide telehealth practice who underwent genetic counseling and cancer risk assessment with a GC after having germline genetic testing. Structured data obtained from multiple care sites via health information networks and manual chart review of electronic medical records was utilized to determine whether patients had bilateral mastectomies after the GC appointment. Results: Of the 460 consecutive patients seen by a GC, 30 were advised to consider bilateral mastectomy, based on their genetic test results and national guidelines. Data was available from the health information networks for all (29/29 (100%)) of these patients who live in the United States, with a mean follow-up of 2.7 years (SD 0.23). These 29 patients had a mean age of 43.3 years (SD 15.3), were all female, and carried mutations in BRCA2 (18/29 (62%)), BRCA1 (6/29 (21%)), or PALB2 (5/30 (17%)). Clinical data was collected from 468 locations, a median of 23 unique locations per patient. At the time of the GC appointment, 7/29 (24%) had active breast cancer, 19/29 (66%) were unaffected, and 3/29 (10%) had a history of previously treated breast cancer. Two patients were diagnosed with breast cancer after the GC appointment. 15/29 (52%) patients underwent bilateral mastectomy after the GC appointment, including most patients with active breast cancer (7/9 (78%)), 8/17 (47%) unaffected patients, and none (0/3 (0%)) with a previously treated breast cancer. Among those without breast cancer, the mean time from the GC appointment to the bilateral risk-reducing mastectomy was 8.6 months (SD 4.4). Conclusions: Half of patients who had bilateral mastectomy indicated because of their genetic test results elected to have mastectomy done after discussion of this guideline-based care option with a GC. As evidenced in prior research, bilateral mastectomy markedly reduces risk of breast cancer. In addition to improved patient outcomes, the revenue a health system receives from these surgeries can also help to support cancer genetics services.
Baseline surveillance in Li Fraumeni syndrome using whole-body MRI: A systematic review and meta-analysis.
Authors: Dacoregio Maria Inez , Reis Pedro Cotta Abrahão , Celso Davi Said Gonçalves , Escalante Romero Lorena , Altmayer Stephan , Vilbert Maysa , Ynoe de Moraes Fabio , Gomy Israel 
Published: June 2024

e22555 Background: Li-Fraumeni syndrome (LFS) is a cancer syndrome associated with early-onset neoplasias. Risk management through a routine cancer surveillance strategy is critical. Since patients with LFS are susceptible to radiation-induced cancers, the use of whole-body MRI (WBMRI) is recommended for regular cancer screening. However, the guidelines for clinical management and the evidence supporting the benefits of WBMRI surveillance in asymptomatic LFS patients are limited. Therefore, this systematic review and meta-analysis assessed the clinical utility of WBMRI in germline TP53 mutation carriers at baseline and at follow up. Methods: We systematically searched Pubmed, Cochrane, and Embase libraries for studies evaluating WBMRI as an early detection method for tumor screening in patients with LFS. We pooled the prevalence and presented the overall rate with 95% confidence intervals (CI) of the individuals found to have one or more investigable lesions, the lesions found to be new cancers among suspicious lesions, and the individuals with one or more new cancers among the total population. Statistical analysis was performed using R software version 4.3.1 and heterogeneity was evaluated with I2 statistics. Results: From 1,547 initial studies, 11 (10 observational cohort and 1 case control) comprising 703 patients (359 females [51%]; mean [SD] age, 29.5 [+/-25] years) were included from 7 different countries. Median follow-up of lesions ranged from 2 to 11 years. We found an estimated detection rate of 31% (95% CI 28-34, I2 55%) of any suspicious lesions in asymptomatic TP53 carriers who underwent baseline WBMRI was found. In total, 277 lesions that required clinical follow-up in 215 patients were identified. Cancer was confirmed in 46 lesions in 39 individuals. Most of the cancers found were Central Nervous System (CNS) tumors (n = 16), followed by sarcomas (n = 12) and breast cancer (n = 11). The estimated cancer diagnosis rate among suspicious lesions was 18% (95%CI 13-25, I2 5%). WBMRI detected 41 of 46 cancers in the early disease stage, with an overall detection rate of 6% (95% CI 5-8, I2 47%). Incidence rate was 2% per patient-round of WBMRI (95% CI 1-4, I2 0%), including baseline plus follow up. Conclusions: Our systematic review and meta-analysis supports that surveillance with WBMRI is effective in detecting cancers in patients with LFS. Additionally, WBMRI surveillance was successful in diagnosing almost 90% of cancers in early-disease stage, which increases the chances os cure in this young population.
Statistical fragility of findings from randomized phase 3 trials in pediatric oncology.
Authors: Olsen Hannah , Kao Pei-Chi , Richmond Caleb , Shulman David Stephen , London Wendy B. , DuBois Steven G. 
Published: June 2024

e23003 Background: The fragility index (FI) and survival-inferred fragility index (SIFI) have been proposed as adjunctive metrics to facilitate interpretation of p-values in clinical trials. FI/SIFI is the number of patients on a positive (p < 0.05) trial’s experimental arm who would need to switch from “responder/non-event” to “non-responder/event” to cause p > 0.05. Fragility indices have been reported previously in medical oncology, with median values < 10 often seen in the literature. This metric has not been studied in pediatric oncology trials. Methods: PubMed was used to identify randomized phase 3 pediatric oncology trials published between 1980-2020. We report trial characteristics and calculate FI for trials with a binary outcome and SIFI for trials with a time-to-event outcome. We also report the fragility quotients (FQ and SFQ) to normalize FI and SIFI relative to trial size. Results: 113 trials included sufficient data for analysis. The median FI for trials with a binary outcome (n = 40) was 4.5 (range: 1-33). The median SIFI for trials with a time-to-event outcome (n = 73) was 13 (range: 0-61). The FI or SIFI was less than the number of patients lost to follow-up in 25% of 36 trials. Median FQ = 0.026 and SFQ = 0.03, indicating that revised outcome in 2.6% or 3% of trial participants would be sufficient to alter the trial conclusion. FQ and SFQ did not significantly vary according to trial characteristics. While sample sizes increased over time (mean 187, 1980s; mean 437, 2010s), FQ and SFQ remained stable between 2-3%. Conclusions: The statistical conclusions of pediatric oncology phase 3 trials hinge on a relatively small number and proportion of patients. Despite sample size limitations of low prevalence diseases, pediatric cancer trials appear similarly or less fragile than adult oncology trials. Fragility was similar for large versus small trials and remained constant over four decades. [Table: see text]