Fractions and trends of cancer burden attributable to population ageing in China / 中华肿瘤杂志

Objective: To analyse the fractions and trends of cancer burden attributable to population ageing, adult population size, age-specific incidence and case fatality rate in China between 1990 and 2019. Methods: We extracted data from the database of Global Disease Burden Study, including the number of cancer cases, deaths and corresponding population of 29 cancer types for Chinese adults aged 25 years and older from 1990 to 2019. Using the cancer deaths in 1990 as a reference, we employed a decomposition method to express cancer deaths as the product of four factors among men and women from 1991 to 2019. The fractions attributable to cancer deaths among total cancer deaths in that year were calculated and its time trends were assessed. Results: In 2019, we estimated that there were 2 690 000 cancer deaths among adults aged 25 and older in China. Of which, cancer deaths attributable to population ageing, adult population size, age-specific cancer incidence and case fatality rate were 740 000 (27.5% of total cancer deaths in 2019), 1 091 000 (40.6%), 198 000 (7.3%) and -728 000 (-27.1%), respectively. In 2019, lung cancer, stomach cancer, esophageal cancer, liver cancer and colorectal cancer ranked the top five cancers among population ageing attributable to cancer deaths. For 29 cancer types, the fractions of population ageing attributable to cancer deaths among total deaths of that cancer were ranged from 9.3% to 40.5%. The ageing attributable to cancer deaths and its fractions were increased rapidly since 1997, while those estimates were negative before 1997. Conclusions: The population ageing process in China was one of the major contributors to the increase in cancer burden in recent years, which has caused more cancer deaths than that by age-specific cancer incidence. Accordingly, activities toward healthy ageing would be the key to cancer prevention and control.

Cancer burden and alarm signals: a community based study from Kerala, India

Background: Cancer is emerging as a major public health concern in many countries including India. Kerala state has the highest burden of cancer in the country. Objective of this study was to estimate the prevalence of diagnosed cancers, warning signs and selected risk factors of cancer in Kadapra Panchayath of Pathanamthitta district, Kerala.Methods: A total of 16,391 population was covered by door to door survey using a structured questionnaire. The questionnaire collected information on the sociodemographic variables of the residents, source of water supply, warning signs of cancer and details of diagnosed cancer cases.Results: The mean age of the population was 40.9+21 years. The prevalence of diagnosed cases of cancer in our study population was 776/100,000 population. Breast cancer was the most common cancer (43.5%) identified in the population. The prevalence of any warning sign among the study population was 220/100,000 population. Breast lump was the common warning sign identified. Increasing age and female gender were the factors found to be significantly associated with cancer.Conclusions: As prevalence of cancer was found to be high in this population, an active community based screening along with teaching self-breast examination to the women in the community are required. Improving community awareness could help in early diagnosis, treatment and prevention. Soil and water testing for carcinogens is recommended.

Does tumor stroma ratio of breast cancer trucut biopsy determine response to neoadjuvant therapy?

Aims and Objectives: We examined the prognostic value of Tumor stroma ratio (TSR) in breast tumor core biopsy (TCB) specimen to determine response to neoadjuvant therapy (NAT) prior to modified radical mastectomy (MRM). Methods: This was a retrospective analysis of patients with breast cancer who underwent TCB before NAT between August 2016 and July 2018. TSR in TCB was studied independently by 2 pathologists ( VM, VS) defined as stroma rich (TSR?50%) or stroma poor (TSR>50%). MRM specimen of these patients were subsequently studied .Residual cancer burden (RCB) was calculated using the MD Anderson RCB calculator, categorized as complete (0), good (1) Partial (2) and no response (3). Statistical analysis was done to assess correlation of TSR to RCB. Results: A total of 62 patients were analyzed. Mean(SD) age was 48(11) years.Twenty eight (45%) and 34 (55%) patients were stroma rich and stroma poor respectively. Twenty six (42%) patients were responders and 36 (58%) non-responders to NAT. Among stroma rich patients, only 3 (10%) were responders (Class 0 &1)and 25 (90%) non-responders(Class2&3)to NAT, among stroma poor patients 23 (68%) responded well and 11 (32%) did not.TSR had a moderate negative correlation with RCB (-0.6). On univariate analysis, only TSR had a significant effect on RCB class (<0.001). Conclusions: TSR on TCB is a useful prognostic factor to determine response of breast carcinoma patients to neoadjuvant therapy.It is cost effective, simple and quick. Larger multi-centric studies would be useful to study its clinical implications.

Setting a Health Policy Research Agenda for Controlling Cancer Burden in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aim of study was to provide suggestions for prioritizing research in effort to reduce cancer burden in Korea based on a comprehensive analysis of cancer burden and Delphi consensus among cancer experts. MATERIALS AND METHODS: Twenty research plans covering 10 topics were selected based on an assessment of the literature, and e-mail surveys were analyzed using a two-round modified Delphi method. Thirty-four out of 79 experts were selected from four organizations to participate in round one, and 21 experts among them had completed round two. Each item had two questions; one regarding the agreement of the topic as a priority item to reduce cancer burden, and the other about the importance of the item on a nine-point scale. A consensus was defined to be an average lower coefficient of variation with less than 30% in importance. RESULTS: Seven plans that satisfied the three criteria were selected as priority research plans for reducing cancer burden. These plans are "research into advanced clinical guidelines for thyroid cancer given the current issue with over-diagnosis," "research into smoking management plans through price and non-price cigarette policy initiatives," "research into ways to measure the quality of cancer care," "research on policy development to expand hospice care," "research into the spread and management of Helicobacter pylori," "research on palliative care in a clinical setting," and "research into alternative mammography methods to increase the accuracy of breast cancer screenings." CONCLUSION: The seven plans identified in this study should be prioritized to reduce the burden of cancer in Korea. We suggest that policy makers and administrators study and invest significant effort in these plans.