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Oncology
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Manar Marzouk, Sarah Catherine Walpole
Healthcare professionals should familiarise themselves with information about cancer epidemiology, risk factors, available screening tests and treatment options – both subsidised and available at a cost. Healthcare professionals can then inform patients about options; some forced migrants may be willing and able to pay out of their own pocket.1 A study of Bhutanese refugees resettled in Nebraska showed that only 22% had heard of a cervical smear test, only 13.9% had had one and only 33.3% thought that they were at risk of cervical cancer (even though rates of cervical cancer are significant in Bhutan).16
Real-World Evidence from Population-Based Cancer Registry Data
Published in Harry Yang, Binbing Yu, Real-World Evidence in Drug Development and Evaluation, 2021
Cancer patients, healthcare providers, public health professionals, cancer researchers, and policy makers all need updated information about newly diagnosed cancer cases and deaths to better understand the impact and address the burden of cancer. Reliable estimates of the cancer burden and trends can provide a comprehensive picture of how the impact of cancer varies between geographic areas and changes temporarily. These cancer estimates provide input to the development of cancer control strategies. Increasingly, survival trends are also used to assess the efficacy of cancer strategies in reducing the impact of cancer over time. Incidence, survival, and mortality are the most popular measures in cancer epidemiology. They have been the principal measures to explore the causes and outcomes of cancer and to assess the effectiveness of cancer management programs. Cancer surveillance includes the monitoring of population levels and trends in incidence, survival, mortality, and prevalence of cancer. In addition, the factors that influence the cancer trends across the entire cancer control continuum, such as healthy populations at risk of cancer, new diagnosis of cancer, treatment of cancer, living with cancer, and dying of cancer or other causes, are also collected. For the analysis and interpretation of the cancer statistics collected by population-based cancer registries, a suite of statistical methodology has been developed by the U.S. National Cancer Institute (NCI) and other institutions throughout the world.
Lifestyle Factors in Cancer Survivorship
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
The correlation between smoking and outcome is not limited to upper tract epithelial cancers. A cohort study compared the lifestyle habits of 365 women with ER+ve breast cancer with matched controls. Smoking was a major risk factor for the development of subsequent contralateral relapse, although the effect was strongest in women who also consumed >7 alcoholic beverages a week and were obese.24 The prospective Life After Cancer Epidemiology (LACE) study followed 2265 women for 25 years; never smokers had a twofold lower rate of dying from breast cancer than smokers. A further analysis of the CALGB 89803 study of 1045 patients with Stage III colon cancer reported an increased relapse rate and worse overall survival among smokers.
Breast cancer-related mortality in Central and Eastern Europe: years of life lost and productivity costs
Published in Journal of Medical Economics, 2023
Goran Bencina, Nour Chami, Robert Hughes, Georgie Weston, Carl Baxter, Adam Maciejczyk, Lazar Popovic, Eugenia Karamousouli, Stina Salomonsson
There are striking variations in cancer epidemiology between European countries, including significant differences in the cancer incidence and mortality8. Central and Eastern Europe (CEE) generally have higher incidence of cancers than other areas9. Excess mortality can be seen in CEE versus western European countries, with a study estimating that over 55,000 cancer deaths could be avoided by closing the mortality gap10. A number of attributable factors could be associated with these regional variations, including: different prevalence of underlying risk factors, inadequacies in screening and early diagnosis, the distribution of cancer types, and different treatment options and follow-up care11. Furthermore, it has been reported that CEE countries spend less per person on pharmaceuticals, and fewer EMA-approved drugs are reimbursed in CEE countries than in other European countries, which could add to the burden of mortality due to later diagnosis and limited treatment options. Although there is a growing body of evidence that recognizes the importance of the clinical and humanistic burden of BC in CEE countries12, few studies have investigated the economic burden of this disease in these regions13.
Approaches for the setting of occupational exposure limits (OELs) for carcinogens
Published in Critical Reviews in Toxicology, 2023
When a single suspected chemical has been studied comprehensively, an apprehension of carcinogenic properties, MoAs, detailed molecular mechanisms, exposure conditions, and so forth can be obtained by combining data from cancer epidemiology, biomarker studies, studies on polymorphisms, cancer test models and earlier and current basic research. The PubMed database (NIH 2020) currently comprises more than 30 million articles. Navigating this literature demands time and training in many scientific subdisciplines. Overviews can be facilitated by employing text analysis software (text-mining tools), which categorise articles found in e.g. PubMed into taxonomies such as those for hallmarks of cancer (Figure 2) or MoAs (Figure 3), respectively (Korhonen et al. 2012; Baker et al. 2017). As PubMed is continuously updated, the text-mining tools capture historical as well as recent research trends, such as those exemplified in Section 3.1. The input can be single substances, natural mixtures, exposure scenarios, groups of chemicals and occupations. The output gives indications about, e.g. genotoxicity and other endpoints. More detailed information can also be obtained for risk assessment by comparing the toxicological profile of a studied chemical with a well-known reference compound or for grouping chemicals with similar properties (Ali et al. 2016). These automatic tools give an overview of the published literature within minutes and can greatly facilitate manual reading, but do not replace careful assessment of critical studies.
Make available anonymous data at the small-residential-area level
Published in Acta Oncologica, 2023
I have argued that data at the small-residential-area level should be prioritised for descriptive cancer epidemiology [2,3]. As compared with using data at a larger geographical scale, such as commonly available data at the regional level, the small-area representation provides more informative estimates on sociodemographic and spatial variations in cancer-related outcomes [4,5]. Linkage of an identifier variable for small areas to individual-level data in cancer screening and care quality registries is feasible [2]. I am not aware of any quality registry that provides open-access data at the small-area level. I believe that there are two main reasons for this lack of open-access data. First, registries have focussed on gathering clinical data on patients (or screened persons), generally leaving out the population perspective. Specifically, registries have not prioritised variables that provide a link to underlying population groups and therefore they miss the opportunity to consider population-wide data on sociodemographic and geographical characteristics [2]. Second, it is unrecognised that data at the small-area level can be kept anonymous.