Trends of cancer incidence and mortality in Cali,Colombia. 50 years experience

Purpose :

The Population-based Cancer Registry of Cali aims to report all new cases in permanent residents within the limits of the city of Cali. Time trends of cancer incidence and mortality are described. The registry has been in continuous operation for 50 years.

Methods:

Cancer cases reports are obtained actively by visiting all sources of information: hospitals, pathology departments, hematology laboratories, radiotherapy centers, government offices where death certificates are processed and physician''s offices. It is estimated that the reporting is at least 95% complete.

Results:

Drastic decreases are documented in rates for tumors causally related to infectious agents, especially cancers of the uterine cervix and the stomach. Gradual increases are documented in rates of tumors linked to affluence and the metabolic syndrome, especially cancers of the colon and the female breast. An unexpected increase in the incidence of papillary carcinoma of the thyroid gland in women is reported. Tobacco-related cancers, especially cancer of the lung, showed marked increase in incidence rates around 1970, apparently the beginning of an epidemic similar to the one reported in Western societies. But the increase in incidence stopped around 1980, resulting from a strong anti-smoking campaign launched in Colombia in the 1970s.

Conclusions:

The findings have influenced prevention strategies implemented by public health authorities, specially the establishment of a city-wide program to prevent cervix cancer via widespread use of vaginal cytology and anti-smoking campaigns. Also, new population-based cancer registries have been established in other Colombian cities as well as in Ecuador.     

Descriptive epidemiology of childhood cancer in Cali: Colombia 1977-2011

Aim:

The objective of the present report is to describe the occurrence and survival patterns of childhood cancer over the last 20 years in Cali.

Methods:

Information was obtained from the Cancer Population Registry in Cali and the Municipal Department of Health . Childhood cancer international classification was used. The vital status was obtained from MDH death certificate and hospital databases. Additionally, clinical records were revised and, in some cases, telephone contact was carried out. Follow-up was done until 31/12/2011. Incident and mortality rates were estimated and adjusted for age. Life-tables were made to estimate overall survival.

Results:

Between the years of 1977-2011, there were 2311 cases identified in children under 15 years of age. The IR and MR for Cali were found to be 141.2 and 55.6 per million of people per year. Leukemias, lymphomas, CNS tumors and soft tissue sarcomas showed IR of 60.1, 20.5, 25.7 and 9.4, respectively. 5-years OS was 48%, and showed an improvement from 24.9%±4.3 to 51.8%±4.6, compared 1992-96 vs 2002-06 periods.

Conclusion:

The IR found is comparable with those described in affluent countries. Taking into account that pediatric cancer is curable for about 75-80% of the cases, it presents an enormous challenge to the Colombian health system: to improve current clinical results.     

Clinical profile and initial treatment of non-small cell lung cancer: a retrospective cohort study at the Uganda Cancer Institute

IntroductionLung cancer is a major global public health burden constituting 11.6% of all new cancer diagnoses and 18.4% of all cancer-related mortalityPurposeTo describe the clinical profile and initial treatment of non-small cell lung cancer in UgandaMethodsWe reviewed charts of a cohort of patients with a histologically confirmed diagnosis of non-small cell lung cancer, treated between January 2013 and November 2015 at the Uganda Cancer Institute.ResultsA total of 74 patients met the inclusion criteria. The median age was 56 years (IQR 47–70), with 16.2% below the age 45 years, and 51% were female. Only 10 percent were active smokers and the most frequent histological subtype was adenocarcinoma (71%). The majority (91.9%) had stage IV disease at diagnosis and frequent metastases to contralateral lung, liver, and bones. Twenty-seven (27) patients received platinum-based chemotherapy, while 27 patients received erlotinib, and only 4 patients received palliative thoracic radiotherapy. The median survival time was 12.4 months, and the overall response rate was 32.7%. There was no survival difference by type of systemic treatment, and on multivariate analysis, poor performance status was predictive of adverse outcomes (p < 0.001).ConclusionsPatients with non-small cell lung cancer in Uganda frequently presented with late-stage disease at diagnosis. The majority of patients were female, never-smokers, and had predominantly adenocarcinoma subtype.     

Cancer Testis Antigens: A Novel Target in Lung Cancer

Lung cancer is the main cause of cancer mortality worldwide. This is mainly due to the fact that it is diagnosed in advanced stage patients, which are no more surgically curable. Consequently, searching for novel treatments and new modalities for early diagnosis offers great promise to improve the clinical outcome. Recently, a new group of antigens, the cancer testis antigens, have been described as possible early diagnostic tools and therapeutic targets in cancer therapy.This review will report emerging evidences of cancer testis antigens deregulation in lung cancer and explore the state of the art of their currently known role and potential as markers for early diagnosis and disease progression and targets of an immunotherapeutic approach aiming to improve the cure rate of this tumor.     

Cancer Testes Antigens in Breast Cancer: Biological Role,Regulation, and Therapeutic Applicability

Breast cancer remains one of the leading causes of death among women across the world. The last few decades have seen significant reduction in mortality owing to earlier detection and better adjuvant treatments that were developed based on clinical staging and morphological features. As these treatments have evolved, the heterogeneity of breast cancer poses a new challenge, since there is no standard gold-therapy suitable for all tumors of the mammary gland. Therefore, contemporary management and research efforts are directed toward specific prognostic and predictive molecular signatures that can guide targeted individualized therapy. The goal of ongoing research in this field is to identify specific molecular targets for developing novel therapeutic approaches. These targets can also serve to improve screening of breast cancer. This review focuses on the role of cancer testis antigens (CTAs) in breast carcinogenesis and explores the potential for development of targeted screening and therapeutic approaches. Normally found in the testes, these antigens are highly correlative with cancers of the breast, skin, and ovaries. These implications have been further corroborated through uncovering the interaction of CTAs with genes and proteins involved in tumor suppression and homeostasis like p53. There is some evidence that these genes can be targeted for early detection in addition to being candidates for cancer immunotherapy.     

Analysis of prognostic factors and treatment modality changes in breast cancer: a single institution study in Korea

PURPOSE: To determine the effects of new breast cancer treatments and to provide a baseline for monitoring the development of breast cancer in Korean women, we conducted an analysis at our institution to determine long-term clinicopathological features, survival rates, and prognostic factors. MATERIALS AND METHODS: This study retrospectively analyzed 2,403 patients between Sep 1994 and Dec 2002, who underwent breast cancer surgery at Samsung Medical Center in Korea. Demographic data, pathologic records and surgical records were collected. RESULTS: After a median follow-up duration of 121.9 (range: 2-158.1) months, the 5-year disease free survival (DFS) was 82.8% and the 10-year DFS was 74.7%. The 5-year and 10-year overall survival (OS) rates were 89.4% and 82.9%, respectively. Using multivariate analyses, we determined that the nodal status (p < 0.001), angioinvasion (p < 0.001), positive PR (p < 0.001), and C-erb-B2 (p < 0.001) were independent prognostic factors for OS. The frequency of breast conserving surgery was 33.9% before Dec 1999, and increased up to 44.1% by year Dec 2002. CONCLUSION: Most of the prognostic variables and clinical characteristics of the Korean breast cancer patients were similar to those reported for Western populations. However, the age distribution in Korean patients seemed to be different from that in patients from Western countries.     

Translation and evaluation of a comprehensive educational program for cardiac rehabilitation patients in Latin America: A multi-national,longitudinal study

ObjectivesTo translate, cross-culturally adapt and validate a comprehensive evidence- and theoretically-based CR education intervention in Latin America.MethodsFirst, best practices in translation and cross-cultural adaptation were applied through 6 steps. Then, the Spanish version was delivered to CR participants from programs in Colombia, Costa Rica and Peru for validation, such that the evaluation was pre-post, uncontrolled, pragmatic, observational, and prospective in design. Participants completed surveys assessing knowledge, health literacy, self-efficacy, and health behaviours. All outcomes were assessed pre-, and post-CR, as well as 6 months after CR completion.ResultsAfter translation of the patient guide from English to Spanish, 5 of the 9 booklets were culturally adapted. Two-hundred and forty-nine patients consented to participate, of which 184 (74 %) completed post-CR, and 121 (48 %) completed final assessments. There was a significant improvement in disease-related knowledge pre- to post-CR, as well as in health literacy, self-efficacy, and health behaviours (all p < 0.05). These gains were sustained 6 months post-program. With adjustment, CR attendance (i.e., exposure to the education) was associated with greater post-CR knowledge (ß = 0.026; p = 0.01).ConclusionA patient education intervention for CR patients in Latin America has been validated, and wider implementation is warranted.Practice implicationsApplication of this first-ever validated CR education program for Spanish-speaking settings may result in secondary prevention.     

miR-342-3p 在乳腺癌中的表达及其与临床病理特征、 远期预后的相关性

目的研究 miR-342-3p 在乳腺癌中表达及其与临床病理特征、 远期预后的相关性。方法选择 2014 年 1 月 ~ 2015 年 2 月期间在南平市第一医院接受乳腺癌根治术的患者作为乳腺癌组, 同期接受手术切 除的乳腺良性肿瘤患者作为对照组, 检测乳腺癌组织及乳腺良性肿瘤组织中 miR-342-3p 的表达水平, 随访 乳腺癌患者的总生存 (OS) 及无病生存 (DFS), 采用 Kaplan-Meier 曲线分析 miR-342-3p 的表达水平与 OS、 DFS 的关系, 采用 COX 比例风险模型分析 OS、 DFS 的影响因素。 在乳腺癌 MCF7 细胞中转染 miR-NC 序列及 miR-342-3p 模拟物, 检测细胞活力水平及 AKT2、 Bcl2L1、 FOXQ1 的表达水平。结果乳腺癌组织 中 miR-342-3p 的表达水平明显低于乳腺良性肿瘤组织 (P< 0. 05), 且不同 T 分期、 淋巴结转移、 分子分 型、 Ki-67 表达的乳腺癌组织间比较, miR-342-3p 表达水平有显著差异 (P< 0. 05)。 Kaplan-Meier 曲线分析 显示, 相比于 miR-342-3p 高表达患者, miR-342-3p 低表达患者的 DFS 和 OS 均缩短。 COX 比例风险模型分 析显示, 淋巴结转移、 Ki-67 表达、 miR-342-3p 表达是乳腺癌患者 DFS 和 OS 的影响因素。 miR-342-3p 高表 达的乳腺癌组织中 AKT2、 Bcl2L1、 FOXQ1 的表达水平低于 miR-342-3p 低表达的乳腺癌组织。 miR-342-3p 组 MCF7 细胞中细胞活力及 AKT2、 Bcl2L1、 FOXQ1 的表达水平均低于 miR-NC 组。结论乳腺癌中 miR-342-5p 低表达且其低表达与病理特征恶化有关, miR-342-5p 低表达是乳腺癌患者预后的影响因素, AKT2、 Bcl2L1、 FOXQ1 可能是 miR-342-5p 参与乳腺癌发展的潜在分子机制。     

Genetic polymorphisms of matrix metalloproteinases in lung, breast and colorectal cancer

The matrix metalloproteinases (MMPs) can degrade various components of the extracellular matrix and are implicated in the development and progression of cancer. There is evidence suggesting an association of MMP gene polymorphisms with cancer susceptibility and/or metastasis. This paper reviews the findings on several single nucleotide polymorphisms in the collagenase, stromelysin and gelatinase genes in lung cancer, breast cancer and colorectal cancer.     

Cancer incidence and mortality in the Bucaramanga metropolitan area, 2003-2007

Introduction:

Cancer is an important cause of morbidity and mortality worldwide. Population-based cancer registries (PBCRs) make possible to estimate the burden of this condition.

Aim:

To estimate cancer incidence and mortality rates in the Bucaramanga Metropolitan Area (BMA) during 2003-2007.

Methods:

Incident cases of invasive cancer diagnosed during 2003-2007 were identified from the Bucaramanga Metropolitan Area PBCR (BMA-PBCR). Population counts and mortality were obtained from the Colombian National Administrative Department of Statistics (NADS). We estimated total and cancer-specific crude incidence and mortality rates by age group and sex, as well as age-standardized (Segi''s world population) incidence (ASIR(W)) and mortality (ASMR(W)) rates. Statistical analyses were conducted using CanReg4 and Stata/IC 10.1.

Results:

We identified 8,225 new cases of cancer excluding non-melanoma skin cancer (54.3% among women). Of all cases, 6,943 (84.4%) were verified by microscopy and 669 (8.1%) were detected only by death certificate. ASIR(W) for all invasive cancers was 162.8 per 100,000 women and 177.6 per 100,000 men. Breast, cervix, colorectal, stomach and thyroid were the most common types of cancer in women. In men, the corresponding malignancies were prostate, stomach, colorectal, lung and lymphoma. ASMR(W) was 84.5 per 100,000 person-years in women and 106.2 per 100,000 person-years in men. Breast and stomach cancer ranked first as causes of death in those groups, respectively.

Conclusion:

Overall, mortality rates in our region are higher than national estimates possibly due to limited effectiveness of secondary prevention strategies. Our work emphasizes the importance of maintaining high-quality, nationwide PBCRs.     

Endometrial cancer survivors are unsatisfied with received information about diagnosis, treatment and follow-up: A study from the population-based PROFILES registry

Objective

To evaluate perceived level of and satisfaction with information received by endometrial cancer survivors, and to identify associations with socio-demographic and clinical characteristics.

Methods

All patients diagnosed with endometrial cancer between 1998 and 2007, registered in the Eindhoven Cancer Registry, received a questionnaire including EORTC-QLQ-INFO25.

Results

Seventy-seven percent responded (n = 742). Most patients indicated receiving quite a bit information about their disease and medical tests. However, most patients were not (54%) or a little (24%) informed about the cause of their disease, and possible side effects (36%; 27%). Especially information about additional help, rehabilitation, psychological assistance, and expected results on social and sexual life was lacking. Five percent was not or a little (36%) satisfied. Four percent found the information not or a little (35%) helpful. Fifteen percent preferred more information. Younger age, more recent diagnosis, radiotherapy, absence of comorbidities, having a partner, having received written information, and higher educational level were associated with higher perceived information receipt.

Conclusion

Many endometrial cancer survivors are unsatisfied with received information. Several areas of information provision are experienced as insufficient.

Practice implications

More patient-tailored information is probably needed to provide optimal information. Implementation of Survivorship Care Plans might be a way to achieve this.     

Comparison of survival models and assessment of risk factors for survival of cardiovascular patients at Addis Ababa Cardiac Center,Ethiopia: a retrospective study

BackgroundCardiovascular diseases (CVDs) is disorders of heart and blood vessels. It is a major health problem across the world, and 82% of CVD deaths is contributed by countries with low and middle income. The aim of this study was to choose appropriate model for the survival of cardiovascular patients data and identify the factors that affect the survival of cardiovascular patients at Addis Ababa Cardiac Center.MethodA Retrospective study was conducted on patients under follow-up at Addis Ababa Cardiac Center between September 2010 to December 2018. The patients included have made either post operation or pre-operation. Out of 1042 cardiac patients, a sample of 332 were selected for the current study using simple random sampling technique. Non-parametric, semi-parametric and parametric survival models were used and comparisons were made to select the appropriate predicting model.ResultsAmong the sample of 332 cardiac patients, only 67(20.2%) experienced CVD and the remaining 265(79.8%) were censored. The median and the maximum survival time of cardiac patients was 1925 and 1403 days respectively. The estimated hazard ratio of male patients to female patients is 1.926214 (95%CI: 1.111917–3.336847; p = 0.019) implying that the risk of death of male patients is 1.926214 times higher than female cardiac patients keeping the other covariates constant in the model. Even if, all semi parametric and parametric survival models fitted to the current data well, various model comparison criteria showed that parametric/weibull AFT survival model is better than the other.ConclusionsThe governmental and non-governmental stakeholders should pay attention to give training on the risk factors identified on the current study to optimize individual''s knowledge and awareness so that death due to CVDs can be minimized.     

Segregation Analysis of Prostate Cancer in France: Evidence for Autosomal Dominant Inheritance and Residual Brother-brother Dependence

Four segregation analyses concerning prostate cancer (CaP), three conducted in the United States and one in Northern Europe, have shown evidence for a dominant major gene but with different parameter estimates. A recent segregation analysis of Australian pedigrees has found a better fit of a two‐locus model than single‐locus models. This model included a dominantly inherited increased risk that was greater at younger ages and a recessively inherited or X‐linked increased risk that was greater at older ages. Recent linkage analyses have led to the detection of at least 8 CaP predisposing genes, suggesting a complex inheritance and genetic heterogeneity. To assess the nature of familial aggregation of prostate cancer in France, segregation analysis was conducted in 691 families ascertained through 691 CaP patients, recruited from three French hospitals and unselected with respect to age at diagnosis, clinical stage or family history. This mode of family inclusion, without any particular selection of the probands, is unique, as probands from all previous analyses were selected according to various criteria. Segregation analysis was carried out using the logistic hazard regressive model, as incorporated in the REGRESS program, which can accommodate a major gene effect, residual familial dependences of any origin (genetic and/or environmental), and covariates, while including survival analysis concepts. Segregation analysis showed evidence for the segregation of an autosomal dominant gene (allele frequency of 0.03%) with an additional brother‐brother dependence. The estimated cumulative risks of prostate cancer by age 85 years, among subjects with the at‐risk genotype, were 86% in the fathers' generation and 99% in the probands' generation. This study supports the model of Mendelian transmission of a rare autosomal dominant gene with high penetrance, and demonstrates that additional genetic and/or common sibling environmental factors are involved to account for the familial clustering of CaP.     

FAM35A/SHLD2/RINN2: A novel determinant of double strand break repair pathway choice and genome stability in cancer

FAM35A, alternatively known as SHLD2 and RINN2, was recently characterized as a DNA repair gene, evolutionarily conserved in higher vertebrates. FAM35A is a 53BP1-pathway factor and a component of the Shieldin/RINN complex. Among 53BP1-pathway factors, FAM35A has unique domains: an N-terminal disordered domain and three C-terminal OB-fold domains. These C-terminal domains have homology with the OB-fold domains of the single-stranded DNA binding protein, RPA1. With other 53BP1-pathway factors, FAM35A inhibits DNA end resection. FAM35A defective cell lines are sensitive to DNA double-strand break inducing agents. Concurrent FAM35A and BRCA1 defects in mammalian cell lines cause resistance to PARP inhibitors and camptothecin. The clinical relevance of this interaction is still unknown, but cancer genomics databases indicate that FAM35A is deleted in 6–13% of prostate cancers and in at least one triple negative breast cancer patient-derived BRCA1 defective cell line. From meta-analysis, FAM35A overexpression in patients with triple negative and basal-like breast cancers is associated with poor survival compared to patients with low expression. From this evidence, clarification of FAM35A's function and the related mechanism of chemoresistance is likely to have clinical implications.     

联合检测血清CA153、CA125、CA199对乳腺癌的临床意义

目的探讨血清CA153、CA125、CA199联合检测对乳腺癌早期诊断的价值。方法采用化学发光法分别检测乳腺癌、乳腺良性疾病患者、体检健康者血清中CA153、CA125、CA199的水平。结果乳腺癌患者血清CA153、CA125、CA199水平均显著高于正常组和良性乳腺疾病组，差异有统计学意义（P〈0.01）；乳腺癌患者术后CA153、CA125、CA199含量较术前显著性下降（P〈0．01），与正常组比较差异无统计学意义（P〉0.05）。CA153、CA125、CA199单独检测乳腺癌的灵敏度分别为54％、36％、30％，特异性为96．6％、91．6％、93．2％．准确性为84、2％、75．1％、74-8％。三者联合检测乳腺癌的灵敏度为78．0％、特异性为88．1％、准确性为85．2％。三项联合检测与单独检测相比灵敏度明显提高（P〈0．05）。结论联合检测血清标志物CA153、CA125、CA199的阳性率、敏感性有较大幅度的提高．三项标志物虽不能作为乳腺癌的特异性指标，但可为临床早期发现、诊断乳腺癌提供十分重要的依据。     

Beckwith Wiedemann syndrome: A population-based study on prevalence,prenatal diagnosis,associated anomalies and survival in Europe

Beckwith Wiedemann syndrome is a complex developmental disorder characterized by somatic overgrowth, macroglossia, abdominal wall defects, neonatal hypoglycemia, and predisposition to embryonal tumors. We present epidemiological and clinical aspects of patients with Beckwith Wiedemann syndrome diagnosed prenatally or in the early years of life, using data from EUROCAT (European Surveillance of Congenital Anomalies) registries. The study population consisted of 371 cases identified between January 1990 and December 2015 in 34 registries from 16 European countries. There were 15 (4.0%) terminations of pregnancy after prenatal detection of severe anomaly/anomalies, 10 fetal deaths (2.7%), and 346 (93.3%) live-births. Twelve (3.6%) of the 330 live-births with available information on survival died in the first week of life, of those eleven (91.6%) were preterm. First-year survival rate was 90.9%. Prematurity was present in 40.6% of males and 33.9% of females. Macrosomia was found in 49.2% and 43.3% of preterm males and females, respectively. Of term newborns, 41.1% of males and 24% of females were macrosomic. Out of 353 cases with known time of diagnosis, 39.9% were suspected prenatally, 36.3% at birth, 7.6% were diagnosed in the first week of life, and 16.2% in the first year of life. The mean gestational age at prenatal diagnosis by obstetric ultrasound was 19.8?±?6.2 (11–39) gestational weeks. The mean prenatal diagnosis of cases where parents opted for termination of pregnancy was 15.3?±?2.4 (11–22) gestational weeks, and the mean gestational age at termination was 19.3?±?4.1 (13–26) gestational weeks. The prenatal detection rate was 64.1% (141/220) with no significant change over time. There were 12.7% of familial cases. The study confirmed the association of assisted reproductive technologies with Beckwith Wiedemann syndrome, as 7.2% (13/181) of patients were conceived by one of the methods of assisted reproductive technologies, which was three times higher compared to the general population of the countries included in the study. Twin pregnancies of undetermined zygosity were recorded in 5.7% (21/365) cases, and were on average three to four times more common than in European countries that participated in the study. The estimated mean prevalence of classical Beckwith Wiedemann syndrome in Europe was 3.8 per 100,000 births or 1:26,000 births.