心脏肿瘤流行病学分析

目的：研究心脏肿瘤流行病学特征。方法：对1998年5月-2000年6月我院心脏手术患者中的38例心脏肿瘤进行流行病学分析。结果：良性肿瘤发生率(92．1％)高于恶性肿瘤(7．9％)。不同年龄发生率也不同，50～59岁年龄段发生率最高，达26．3％，其次为40～49岁年龄段(21．1％)。女性发生率高于男性，这一现象在黏液瘤更为明显。结论：心脏肿瘤发生率较低，且绝大多数为良性肿瘤。     

肺癌流行病学研究进展

肺癌在20世纪末已成为各种癌症死亡的首要原因，目前发病率仍呈上升趋势。第十一届世界肺癌大会会议期间来自世界各地的研究者以不同形式报告了近年来关于肺癌流行病学研究的最新成果，包括肺癌发病及其与环境因素、饮食习惯、营养代谢、种族、性别、年龄以及遗传学改变的关系，此外还对吸烟等因素的干预性研究结果进行了报告。本文就会议中有关内容作一简介。     

常见消化道癌的移民流行病学研究 (综述)

肿瘤流行病学是研究肿瘤在人群中发展水平、分布规律,发生原因和预防措施的科学。它是带头学科之一。移民肿瘤的流行病学研究,具有特殊意义。移民流行病学研究的评价肿瘤的危险性大,不容许用人作试验。动物和人对致癌物的敏感度有很大差别,不能单靠动物实验结果来解释,流行病学方法对肿瘤病因研究上有特殊作用。移民肿瘤流行病学的     

肿瘤分子流行病学研究进展

肿瘤分子流行病学研究进展游伟程分子流行病学是采用流行病学方法结合分子生物学的理论和技术，在有代表性人群中个体的分子水平上对环境致癌物在体内的暴露，代谢过程，与靶器官ＤＮＡ大分子作用，由此引起癌基因结构及表达异常方面进行研究的新兴分枝。探索和说明人类致...     

心脏肿瘤流行病学分析

目的 :研究心脏肿瘤流行病学特征。方法 :对 1998年 5月 - 2 0 0 0年 6月我院心脏手术患者中的 38例心脏肿瘤进行流行病学分析。结果 :良性肿瘤发生率 (92 1% )高于恶性肿瘤 (7 9% )。不同年龄发生率也不同 ,5 0～ 5 9岁年龄段发生率最高 ,达 2 6 3% ,其次为 4 0～ 4 9岁年龄段 (2 1 1% )。女性发生率高于男性 ,这一现象在黏液瘤更为明显。结论 :心脏肿瘤发生率较低 ,且绝大多数为良性肿瘤     

肿瘤描述流行病学

描述性研究是流行病学研究的基础,并通过初步分析,找出影响分布差异的可能因素,提出进一步研究的方向或初步防治对策。肿瘤描述流行病学是根据日常记录资料或通过特殊调查所得到的资料,包括实验检查结果,按不同地区、不同时间和不同人群特征分组,将人群肿瘤分布情况真实地展现出来。研究方法包括常规资料分析与应用、现况研究、筛检和生态学研究等。     

肝癌病理流行病学研究现状

肝癌病理流行病学研究现状顾公望，周汉高肝癌病理流行病学是用流行病学方法研究肝癌病理的学科，其为肝癌病因和防治研究开辟了一条新的途径。就世界而言，不论是肝癌高发或低发国家，在尸检中肝癌发病率都呈上升趋势［１－４］１病因意义。世界各地肝癌周围组织的ＨＰｓ...     

流行病学在癌症研究中的应用

流行病学用于癌症研究的历史虽短,但对癌症病因的深入研究作出了重大贡献。1950、1952年Doll和Hill发表了吸烟与肺癌关系的经典著作;1957年Court Brown和Doll又发表了放射线和白血病的关系的论文以来,流行病学方法在癌症病因研究中日益被重视,1977年国际癌症研究所(IARC)统计,当时全世界正在进行的癌症流行病学科研有900多项。流行病学在癌症病因研究中十分重要,因为只有了解了病因才能采取一级预防措施,即防癌于未然。应用流行病学研究病因,常采用下述步     

遗传流行病学在肿瘤病因研究中的应用

遗传流行病学是遗传学与流行病学相互渗透产生的一门完整的独立的边缘学科，结合了流行病、生物统计学方法与分子遗传学技术。它是群体遗传学中最年轻和发展最快的分支。遗传流行病学在肿瘤病因研究中发挥着越来越重要的作用，通过遗传流行病学研究阐明遗传与环境在肿瘤发生发展中的相互关系。若存在先天因素，则研究其遗传模式，确定易感基因。     

原发性肝癌病理流行病学研究进展

肝癌病理流行病学是用流行病学方法研究肝癌病理的学科，其为肝癌病因和防治研究开辟了一条新的途径。就世界而言，不论是肝癌高发或低发国家，在尸检中肝癌发病率都呈上升趋势〔１－４〕。一、病因意义世界各地肝癌周围肝组织的ＨＢｓＡｇ阳性率差异甚大，德国９．５２％...     

Risk perception among women receiving genetic counseling: a population-based follow-up study

Background: We aimed to explore the impact of genetic counseling on perceived personal lifetime risk of breast cancer, the accuracy of risk perception, and possible predictors of inaccurate risk perception 1 year following counseling. Methods: We conducted a population-based prospective follow-up study of 213 women who received genetic counseling for hereditary breast and ovarian cancer, 319 women who underwent mammography (Reference Group I), and a random sample of 1070 women from the general population (Reference Group II). Results: Women who received genetic counseling decreased their perceived risk by an average of 6.6 percentage points (95% CI: 3.0%; 10.2%) between baseline and 12 months of follow-up. In contrast, perceived risk remained relatively stable in the reference groups. The proportion of women who accurately perceived their risk increased by 16% in the group receiving genetic counseling, compared to a reduction of 5% (p = 0.03) and 2% (p = 0.01) in Reference Groups I and II, respectively. Risk communicated only in words, inaccurate risk perception at baseline, and presence of a familial mutation appeared to be predictors of inaccurate risk perception 12 months after counseling. Conclusion: This population-based study of women with a family history of breast or ovarian cancer indicates that genetic counseling can help them both to reduce their perceived risk and to achieve a more realistic view of their risk of developing breast cancer.     

Estimation of individualized probabilities of developing breast cancer for Japanese women

BACKGROUND: Projecting individualized probabilities of developing breast cancer is needed for counseling and chemoprevention for Japanese women, in whom breast cancer incidence has been rapidly increasing. METHODS: We calculated individualized probabilities of developing breast cancer within 10-20 years and until life expectancy for Japanese women by multiplying the relative risk for each risk factor combination by the cumulative risk for the reference group. The risk factors used were age at menarche, age at first delivery, family history of breast cancer, and body mass index (BMI) (in post-menopausal women). The relative risk by menopausal status for each risk factor combination was estimated from a case control study conducted at Osaka Medical Center for Cancer and Cardiovascular Diseases (OMCC), Japan. The cumulative risk of breast cancer for the reference group within 10-20 years and until life expectancy was estimated to divide the corresponding cumulative risk for Japanese women by the weighted average of the relative risk. The weight is an expected proportion of those who have each risk factor combination among the general population. The cumulative risk for Japanese women was estimated using a data file from the Osaka Cancer Registry (OCR). RESULTS: We obtained cumulative risks for any age women within a certain range according to various risk factor combinations by menopausal state. For example, the highest risk group had about a 5 times higher risk probability of developing breast cancer than the general population at initial age 40, within 10-20 years, and until life expectancy. CONCLUSION: The cumulative risk of breast cancer varied according to individuals' risk factors among Japanese women. The availability of concrete individualized risk estimation figures will be of use to health care providers in encouraging Japanese women to seek counseling and to adopt self-control of body weight as a primary preventive measure, as well as to have breast cancer screening.     

武汉市城区居民肺癌危险因素研究

 目的 探讨武汉市肺癌主要危险因素,为采取切实可行的防治措施提供依据。方法 采用病例对照研究方法,收集370例肺癌病例和符合条件的对照740例进行问卷调查,应用条件Logistic回归分析方法进行单因素和多因素的分析,并计算每个危险因素的PAR%。结果 武汉市城区肺癌主要危险因素有室内化学物污染、吸烟、被动吸烟、精神压抑、肺部疾患史、新鲜蔬菜和水果摄入少等。男性肺癌归因于吸烟的比例为最高;女性肺癌主要归因于新鲜蔬菜摄入少、体重指数、体育锻炼、厨房油烟。结论精神压抑、室内化学物污染、吸烟、被动吸烟、新鲜蔬菜摄入少、呼吸系统疾病史、厨房油烟等因素可以解释武汉市城区90%左右的肺癌发病。而吃蔬菜较多、参加体育锻炼、心理健康等为肺癌发病的保护因素。     

Induction Therapy and Survival for Acute Myeloid Leukemia in Hispanic Adults from Puerto Rico

BackgroundAcute myeloid leukemia (AML) is the most common type of leukemia in adults. There are no previous studies evaluating AML treatment patterns in Puerto Rico. We describe the first-line therapy patterns and survival of patients diagnosed with AML in Puerto Rico using the Puerto Rico Central Cancer Registry Health Insurance Linkage Database (2011-2015).MethodsWe describe patient characteristics according to intensive, non-intensive, and non-treatment status. We used Cox proportional hazard models to evaluate the factors associated with the risk of death stratified by intensive and non-intensive therapy. For this study, 385 patients with AML were included.ResultsThe mean age was 67 years old and 50.1% were female. Nearly half of AML patients (46.8%) received intensive treatment, 23.6% received non-intensive treatment, and 26.2% did not receive treatment. The overall 3-year survival rate was 17.9%. Among those who received intensive therapy, the risk of death among females was lower than males (hazard ratio [HR]: 0.64, 95% confidence interval [CI]: 0.44-0.93). Patients 60 years or older who received intensive treatment had a higher risk of death than younger patients (HR: 1.67, 95% CI: 1.09-2.55). Patients with poor/adverse risk receiving intensive (HR: 3.43, 95% CI: 1.76-6.69) or non-intensive (HR: 4.32, 95% CI: 1.66-11.28) treatment had a higher risk of death than patients with a favorable risk category.ConclusionOur findings are the first step to monitor the quality of care of patients with AML in Puerto Rico, particularly related to the administration of appropriate induction therapies, which is one of the most important predictors of AML survival.     

Psychological impact of health risk appraisal of Korean women at different levels of breast cancer risk: neglected aspect of the web-based cancer risk assessment tool

Objective: Health risk appraisal is often utilized to modify individual’s health behavior, especially concerning disease prevention, and web-based health risk appraisal services are being provided to the general public in Korea. However, little is known about the psychological effect of the health risk appraisal even though poorly communicated information by the web-based service may result in unintended adverse health outcomes. This study was conducted to explore the psychological effect of health risk appraisal using epidemiological risk factor profile. Methods: We conducted a randomized trial comparing risk factor list type health risk appraisal and risk score type health risk appraisal. We studied 60 women aged 30 years and older who had no cancer. Anxiety level was assessed using the Spielberger State-Trait Anxiety Inventory YZ. Results: The results of multivariate analysis showed that risk status was the independent predictors of increase of state anxiety after health risk appraisal intervention when age, education, health risk appraisal type, numeracy, state anxiety, trait anxiety, and health risk appraisal type by risk status interaction was adjusted. Women who had higher risk status had an odd of having increased anxiety that was about 5 times greater than women who had lower risk status. Conclusions: Our findings indicate that communicating the risk status by individual health risk appraisal service can induce psychological sequelae, especially in women having higher risk status. Hospitals, institutes, or medical schools that are operating or planning to operate the online health risk appraisal service should take side effects such as psychological sequelae into consideration.     

EORTC Progression Score Identifies Patients at High Risk of Cancer-Specific Mortality After Radical Cystectomy for Secondary Muscle-Invasive Bladder Cancer

BackgroundThe aim of this study was to develop a risk stratification of patients with muscle-invasive bladder cancer (MIBC) after radical cystectomy (RC). For this purpose, we compared the cancer-specific mortality (CSM) of patients with primary MIBC and patients with secondary MIBC in different risk groups according to the European Organisation for Research and Treatment of Cancer (EORTC) progression score.Patients and MethodsThe records of 521 consecutive patients treated with RC for clinical MIBC according to transurethral resection of bladder cancer (TURBT) diagnosis were reviewed. Of the 521 patients, 399 (76.6%) had primary MIBC (study group 1 [SG1]) and 122 (23.4%) had secondary MIBC (study group 2 [SG2]). Patients in SG2 were stratified into risk groups according to the results of the first and last TURBT in non-MIBC using the EORTC progression score.ResultsCSM for patients with primary and secondary MIBC did not differ significantly. Patients in SG2 with the highest risk for tumor stage progression at time of the first and last TURBT in non-MIBC showed a significantly higher CSM after RC compared with patients with low-to-intermediate risk and compared with patients in SG1. In multivariable analyses, stage pT 3/4 (hazard ratio [HR], 2.12; P < .001), lymphovascular invasion (LVI) (HR, 3.47; P < .001), female sex (HR, 1.35; P = .048), and time from diagnosis of MIBC to RC > 90 days (HR, 2.07; P < .001) were significantly associated with higher CSM.ConclusionRisk stratification by the EORTC progression score can help to identify those patients with the highest risk of CSM after progression to MIBC and thus enable us to offer these patients a multimodal treatment. Our results need to be verified in large prospective studies.     

Characterization of Patients With Poor-Risk Metastatic Renal-Cell Carcinoma: Results From a Pooled Clinical Trials Database

Background

Poor-risk patients with metastatic renal-cell carcinoma remain poorly characterized in prospective clinical trials. Therefore, we sought to provide a comprehensive analysis of this patient population, defined by 3 widely used prognostic models, treated with targeted therapy.

Differences and similarities in breast cancer risk assessment models in clinical practice: which model to choose?

To show differences and similarities between risk estimation models for breast cancer in healthy women from BRCA1/2-negative or untested families. After a systematic literature search seven models were selected: Gail-2, Claus Model, Claus Tables, BOADICEA, Jonker Model, Claus-Extended Formula, and Tyrer–Cuzick. Life-time risks (LTRs) for developing breast cancer were estimated for two healthy counsellees, aged 40, with a variety in family histories and personal risk factors. Comparisons were made with guideline thresholds for individual screening. Without a clinically significant family history LTRs varied from 6.7% (Gail-2 Model) to 12.8% (Tyrer–Cuzick Model). Adding more information on personal risk factors increased the LTRs and yearly mammography will be advised in most situations. Older models (i.e. Gail-2 and Claus) are likely to underestimate the LTR for developing breast cancer as their baseline risk for women is too low. When models include personal risk factors, surveillance thresholds have to be reformulated. For current clinical practice, the Tyrer–Cuzick Model and the BOADICEA Model seem good choices.