Cancer statistics for Hispanics/Latinos, 2012

Hispanics/Latinos are the largest and fastest growing major demographic group in the United States, accounting for 16.3% (50.5 million/310 million) of the US population in 2010. In this article, the American Cancer Society updates a previous report on cancer statistics for Hispanics using incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. In 2012, an estimated 112,800 new cases of cancer will be diagnosed and 33,200 cancer deaths will occur among Hispanics. In 2009, the most recent year for which actual data are available, cancer surpassed heart disease as the leading cause of death among Hispanics. Among US Hispanics during the past 10 years of available data (2000‐2009), cancer incidence rates declined by 1.7% per year among men and 0.3% per year among women, while cancer death rates declined by 2.3% per year in men and 1.4% per year in women. Hispanics have lower incidence and death rates than non‐Hispanic whites for all cancers combined and for the 4 most common cancers (breast, prostate, lung and bronchus, and colorectum). However, Hispanics have higher incidence and mortality rates for cancers of the stomach, liver, uterine cervix, and gallbladder, reflecting greater exposure to cancer‐causing infectious agents, lower rates of screening for cervical cancer, differences in lifestyle and dietary patterns, and possibly genetic factors. Strategies for reducing cancer risk among Hispanics include increasing utilization of screening and available vaccines, as well as implementing effective interventions to reduce obesity, alcohol consumption, and tobacco use. CA Cancer J Clin 2012;. © 2012 American Cancer Society.     

Recent progress in understanding,diagnosing, and treating hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is one of the few cancers in which a continued increase in incidence has been observed over several years. As such, there has been a focus on safe and accurate diagnosis and the development of treatment algorithms that take into consideration the unique complexities of this patient population. In the past decade, there have been improvements in nonsurgical treatment platforms and better standardization with respect to the diagnosis and patient eligibility for liver transplant. How to navigate patients through the challenges of treatment is difficult and depends on several factors: 1) patient‐related variables such as comorbid conditions that influence treatment eligibility; 2) liver‐related variables such as Child‐Pugh score; and 3) tumor‐related variables such as size, number, pattern of spread within the liver, and vascular involvement. The objectives of this review are to put into perspective the current treatment options for patients with HCC, the unique advantages and disadvantages of each treatment approach, and the evidence that supports the introduction of sorafenib into the multidisciplinary management of HCC. CA Cancer J Clin 2012;. © 2012 American Cancer Society.     

The global incidence of lip,oral cavity,and pharyngeal cancers by subsite in 2012

By using data from the International Agency for Research on Cancer publication Cancer Incidence in 5 Continents and GLOBOCAN, this report provides the first consolidated global estimation of the subsite distribution of new cases of lip, oral cavity, and pharyngeal cancers by country, sex, and age for the year 2012. Major geographically based, sex‐based, and age‐based variations in the incidence of lip, oral cavity, and pharyngeal cancers by subsite were observed. Lip cancers were highly frequent in Australia (associated with solar radiation) and in central and eastern Europe (associated with tobacco smoking). Cancers of the oral cavity and hypopharynx were highly common in south‐central Asia, especially in India (associated with smokeless tobacco, bidi, and betel‐quid use). Rates of oropharyngeal cancers were elevated in northern America and Europe, notably in Hungary, Slovakia, Germany, and France and were associated with alcohol use, tobacco smoking, and human papillomavirus infection. Nasopharyngeal cancers were most common in northern Africa and eastern/southeast Asia, indicative of genetic susceptibility combined with Epstein‐Barr virus infection and early life carcinogenic exposures (nitrosamines and salted foods). The global incidence of lip, oral cavity, and pharyngeal cancers of 529,500, corresponding to 3.8% of all cancer cases, is predicted to rise by 62% to 856,000 cases by 2035 because of changes in demographics. Given the rising incidence of lip, oral cavity, and pharyngeal cancers and the variations in incidence by subsites across world regions and countries, there is a need for local, tailored approaches to prevention, screening, and treatment interventions that will optimally reduce the lip, oral cavity, and pharyngeal cancer burden in future decades. CA Cancer J Clin 2017;67:51–64. © 2016 American Cancer Society .     

Long‐term incidence of breast cancer by trial arm in one county of the Swedish Two‐County Trial of mammographic screening

BACKGROUND:

This study estimated the excess incidence (overdiagnosis) of breast cancer associated with starting mammographic screening at an earlier age, by using data from the Dalarna County component of the Swedish Two‐County Trial of breast cancer screening.

METHODS:

In Dalarna County, Sweden, 38,589 women aged 40 to 74 years were randomized to invitation to regular mammographic screening (active study population [ASP]) and 18,582 women to usual care (passive study population [PSP]). After 3 screening rounds (6‐8 years after randomization), the PSP was invited to screening. The cumulative incidence of breast cancer was calculated in the ASP and PSP from randomization to 29 years later. In addition, cumulative incidence was calculated for invasive cancers, advanced invasive cancers (≥2 cm in maximum diameter or node‐positive), and nonadvanced cancers (<2 cm and node negative).

RESULTS:

There was no excess of cancers in the ASP at 29 year follow‐up (relative risk, 1.00; 95% confidence interval, 0.92‐1.08). Cumulative incidence in the 2 arms approximately equalized at the conclusion of the first round of screening of the PSP. There was an excess of nonadvanced cancers and a deficit of advanced cancers in the ASP, both of which persisted to 29 years.

CONCLUSIONS:

There was no additional breast cancer incidence associated with 100,000 additional screens in the ASP. Results suggest that overdiagnosis is small and largely confined to the prevalence screen. Cancer 2012. © 2012 American Cancer Society.     

Cancer risks associated with external radiation from diagnostic imaging procedures

The 600% increase in medical radiation exposure to the US population since 1980 has provided immense benefit, but increased potential future cancer risks to patients. Most of the increase is from diagnostic radiologic procedures. The objectives of this review are to summarize epidemiologic data on cancer risks associated with diagnostic procedures, describe how exposures from recent diagnostic procedures relate to radiation levels linked with cancer occurrence, and propose a framework of strategies to reduce radiation from diagnostic imaging in patients. We briefly review radiation dose definitions, mechanisms of radiation carcinogenesis, key epidemiologic studies of medical and other radiation sources and cancer risks, and dose trends from diagnostic procedures. We describe cancer risks from experimental studies, future projected risks from current imaging procedures, and the potential for higher risks in genetically susceptible populations. To reduce future projected cancers from diagnostic procedures, we advocate the widespread use of evidence‐based appropriateness criteria for decisions about imaging procedures; oversight of equipment to deliver reliably the minimum radiation required to attain clinical objectives; development of electronic lifetime records of imaging procedures for patients and their physicians; and commitment by medical training programs, professional societies, and radiation protection organizations to educate all stakeholders in reducing radiation from diagnostic procedures. CA Cancer J Clin 2012. © 2012 American Cancer Society.     

Trends in esophageal adenocarcinoma incidence and mortality

BACKGROUND:

Over the past several decades, the incidence of esophageal adenocarcinoma (EAC) has rapidly increased. The purpose of this analysis was to examine temporal trends in EAC incidence and mortality within the US population and, in addition, to explore these trends within subgroups of the population.

METHODS:

The National Cancer Institute (NCI) Surveillance, Epidemiology and End Results (SEER 9) data were used to examine incidence and incidence‐based (IB) mortality in EAC from 1975 to 2009. Secular trends in incidence and IB mortality by cancer stage, sex, and race were further characterized using the NCI's Joinpoint Regression program.

RESULTS:

Based on SEER 9 data, EAC incidence and IB mortality continues to increase in the United States. However, since the mid‐1990s, the overall rate of increase in both EAC incidence and IB mortality appears to be slowing. In addition, in early‐stage cancers, there is a noticeable leveling off of IB mortality rates and divergence from incidence starting in the late 1990s. Over the study period, the average annual percentage increase in incidence was 6.1% in men and 5.9% in women.

CONCLUSIONS:

EAC incidence and IB mortality rates continue to rise in the United States, although at a slower rate in more recent years. In early‐stage cancers, IB mortality and incidence rates have diverged primarily because IB mortality rates have plateaued beginning in the late 1990s. Although EAC continues to be less common in women, the rate of increase in EAC incidence is similar in both sexes. Cancer 2013. © 2012 American Cancer Society.     

Turn Off the IDO: Will Clinical Trials Be Successful?

Summary: Indoleamine 2,3-dioxygenase (IDO) is overexpressed in many human cancers and is believed to play a role in tumor immune evasion, but a requirement for IDO in tumor progression has not been formally shown. The study by Smith and colleagues in this issue of Cancer Discovery provides genetic evidence for the importance of IDO in tumorigenesis, which supports the use of IDO inhibitors in clinical trials in humans. Cancer Discov; 2(8); 673-5. ?2012 AACR.     

A note from history: Landmarks in history of cancer, part 4

In the second half of the 19th century, most cancer patients were cared for by surgeons who exerted ascesis and limited their operations to 1 or 2 specific areas. To assist surgeons and other physicians in caring for their patients, pathologists described newly discovered entities, refined the microscopic classification of tumors, and introduced the grading of cancers. The discoveries of Rontgen and the Curies revolutionized the diagnosis and treatment of cancers. The search for the cause of cancers extended to infectious organisms, chemicals, and radioactive materials. The 50 years covered in this review formed the groundwork for the coordinated, specialized care of cancer patients at institutions dedicated to render the most promising treatment. Cancer 2012. © 2012 American Cancer Society.     

Cancer burden in Africa and opportunities for prevention

Cancer is an emerging public health problem in Africa. About 715,000 new cancer cases and 542,000 cancer deaths occurred in 2008 on the continent, with these numbers expected to double in the next 20 years simply because of the aging and growth of the population. Furthermore, cancers such as lung, female breast, and prostate cancers are diagnosed at much higher frequencies than in the past because of changes in lifestyle factors and detection practices associated with urbanization and economic development. Breast cancer in women and prostate cancer in men have now become the most commonly diagnosed cancers in many Sub‐Saharan African countries, replacing cervical and liver cancers. In most African countries, cancer control programs and the provision of early detection and treatment services are limited despite this increasing burden. This paper reviews the current patterns of cancer in Africa and the opportunities for reducing the burden through the application of resource level interventions, including implementation of vaccinations for liver and cervical cancers, tobacco control policies for smoking‐related cancers, and low‐tech early detection methods for cervical cancer, as well as pain relief at the palliative stage of cancer. Cancer 2012. © 2012 American Cancer Society.     

Multiparametric prostate magnetic resonance imaging in the evaluation of prostate cancer

Imaging has traditionally played a minor role in the diagnosis and staging of prostate cancer. However, recent controversies generated by the use of prostate‐specific antigen (PSA) screening followed by random biopsy have encouraged the development of new imaging methods for prostate cancer. Multiparametric magnetic resonance imaging (mpMRI) has emerged as the imaging method best able to detect clinically significant prostate cancers and to guide biopsies. Here, the authors explain what mpMRI is and how it is used clinically, especially with regard to high‐risk populations, and we discuss the impact of mpMRI on treatment decisions for men with prostate cancer. CA Cancer J Clin 2016;66:326‐336. © 2015 American Cancer Society     

Spatial spectral imaging as an adjunct to the Bethesda classification of thyroid fine‐needle aspiration specimens

BACKGROUND:

Thyroid fine‐needle aspiration (FNA) biopsy, the preoperative diagnostic standard of care for patients with thyroid nodules, has limitations. Spectral imaging captures visible light information that is beyond the capability of the human eye, potentially increasing the accuracy of FNA biopsy. In the current study, the authors demonstrated the feasibility of using spectral imaging in combination with automated spatial analysis based on trainable pattern recognition as an adjunct test for thyroid FNA classification by developing an algorithm that distinguishes between images of papillary thyroid carcinoma (PTC) and benign goiter (BG).

METHODS:

A multispectral camera was used to capture spectral images representing 100 cases of PTC and BG. Used in conjunction with commercial software, 10 cases were used as a training set to develop a “classifier,” a classification algorithm that segments digitized multispectral images into regions of PTC, BG, and “nonfeature.” This algorithm was used to generate a screening test and a diagnostic test that were validated on an independent set of images representing 30 cases of PTC and 30 cases of BG.

RESULTS:

The area under the receiver operating characteristic for the PTC/BG classifier was 0.90. The screening test had a sensitivity of 0.93 and a specificity of 0.73. The diagnostic test had a sensitivity of 0.70 and a specificity of 0.90.

CONCLUSIONS:

The authors developed image classification tests that distinguish between FNAs of PTC and BG, demonstrating the potential value of spatial spectral imaging as an adjunct test for the classification of thyroid FNA samples. The data support prospective testing to determine the value of the PTC/BG classifier in routine clinical use. Cancer (Cancer Cytopathol) 2013. © 2012 American Cancer Society.     

Screen-detected and interval colorectal cancers in England: Associations with lifestyle and other factors in women in a large UK prospective cohort

Faecal occult blood (FOB) - based screening programmes for colorectal cancer detect about half of all cancers. Little is known about individual health behavioural characteristics which may be associated with screen-detected and interval cancers. Electronic linkage between the UK National Health Service Bowel Cancer Screening Programme (BCSP) in England, cancer registration and other national health records, and a large on-going UK cohort, the Million Women Study, provided data on 628,976 women screened using a guaiac-FOB test (gFOBt) between 2006 and 2012. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated by logistic and Cox regression for associations between individual lifestyle factors and risk of colorectal tumours. Among screened women, 766 were diagnosed with screen-detected colorectal cancer registered within 2 years after a positive gFOBt result, and 749 with interval colorectal cancers registered within 2 years after a negative gFOBt result. Current smoking was significantly associated with risk of interval cancer (RR 1.64, 95%CI 1.35–1.99) but not with risk of screen-detected cancer (RR 1.03, 0.84–1.28), and was the only factor of eight examined to show a significant difference in risk between interval and screen-detected cancers (p for difference, 0.003). Compared to screen-detected cancers, interval cancers tended to be sited in the proximal colon or rectum, to be of non-adenocarcinoma morphology, and to be of higher stage.     

Years of life lost as a measure of cancer burden on a national level

Background:

The severity of cancers is often measured in number of deaths. However, number of years of life lost (YLL) may be a more appropriate indicator of impact on society. Here we have calculated the YLL of adult cancers in Norway for the year 2012, as well as for the previous 15-year period.

Methods:

Data on age composition, expected remaining years of life, total numbers of deaths and deaths due to cancer were retrieved from the National Census Agency Statistics Norway. YLL were calculated for both sexes aged 25–99 years based on each individual''s age at death, and the expected remaining years of life at that age.

Results:

Cancer deaths represented 25.8% of all adult deaths in 2012, with a lower fraction of females (28.7% in men and 23.1% in women), whereas cancer represented 35.2% of all YLL, with a higher fraction of females (32.8% in men and 37.8% in women). Females loose on average more life years to cancer than men (14.9 vs 12.7 years). Average YLL varied from 23.7 (cervical cancer) to 7.9 (prostate cancer). Lung cancer caused almost as many YLL alone (22.1% of cancer-caused YLL) as colon, prostate and breast cancer combined (23.1%). From 1997 to 2012, cancer-caused YLL as a fraction of all YLL increased from 32.5% to 35.2%, but with major differences among diagnoses.

Conclusions:

Cancer is a major and increasing cause of premature deaths, and YLL may be a more accurate measure than number of deaths. Public health efforts and research funding should be explicitly directed at preventing premature deaths.     

Incidence of Colorectal Cancer in Selected Countries of Latin America: Age-Period-Cohort Effect

Objective: To estimate Age-Period-Cohort effects on colorectal, colon and rectal cancer incidence rates in Latin American countries covered by high quality Population-Based Cancer Registries. Methods: A trend study was performed using data from Cancer Incidence in Five Continents. Age-Period-Cohort effects were estimated by Poisson regression for individuals aged between 20 and 79 years with colorectal, colon and rectal cancers informed by Population-Based Cancer Registries from 1983 to 2012 in Cali (Colombia); from 1983 to 2007 in Costa Rica; and from 1988 to 2012 for both Goiânia (Brazil) and Quito (Ecuador). Goodness of fit model was tested using the deviance of the models. Results: Age effect was statistically significant for both sexes in all Population-Based Cancer Registries areas and the curves slope reached peaks in the older age groups. There were cohort effects on the incidence rates for colorectal, colon and rectal cancers in all Population-Based Cancer Registries areas, except for women in Quito. Regarding the period effect, an increased ratio rate was observed in men (1.26, 95%CI 1.17 to 1.35) and women (1.23, 95%CI, 1.15 to 1.32) in Goiânia, between 2003 and 2007. Conclusions: In Latin America, age effect was observed on incidence rates for colorectal, colon and rectal cancers. Besides, birth cohort effect was identified for recent cohorts in both genders for colorectal, colon and rectal cancers in Cali and Goiânia, and cohort effect for colorectal and colon cancers in both genders in Costa Rica; while in Quito a cohort effect was only observed for rectal cancer among men. Period effect was observed in Goiânia with increased ratio rate in 2003-2007.     

The role of human papillomavirus in nongenital cancers

Answer questions and earn CME/CNE Human papillomavirus (HPV), one of the most common sexually transmitted diseases worldwide, has an established role in the pathogenesis of genital malignancies such as cervical cancer. The virus has also been implicated in the oncogenesis of nongenital cancers including head and neck malignancies (specifically oropharyngeal cancers) as well as anal cancer. There is less clarity regarding its role in lung and esophageal cancers. Worldwide, the incidence and prevalence of HPV‐associated oropharyngeal cancer has been increasing over time. These patients have improved outcomes compared with those with HPV‐negative oropharyngeal cancers, and there is continued interest in designing treatments specifically for this HPV‐positive subgroup. Clinicians continue to gain an understanding of HPV in anal cancers and the risk factors associated with infection and progression to malignancy. This has potential implications for the eventual screening of high‐risk groups. While HPV vaccination is currently approved for the prevention of cervical cancer, it also has potential in the prevention of all HPV‐associated malignancies. In this review, current understanding of the role of HPV in nongenital cancers is discussed, as well as future implications for treatment and prevention. CA Cancer J Clin 2013. © 2012 American Cancer Society.     

Breast cancer statistics, 2015: Convergence of incidence rates between black and white women

In this article, the American Cancer Society provides an overview of female breast cancer statistics in the United States, including data on incidence, mortality, survival, and screening. Approximately 231,840 new cases of invasive breast cancer and 40,290 breast cancer deaths are expected to occur among US women in 2015. Breast cancer incidence rates increased among non‐Hispanic black (black) and Asian/Pacific Islander women and were stable among non‐Hispanic white (white), Hispanic, and American Indian/Alaska Native women from 2008 to 2012. Although white women have historically had higher incidence rates than black women, in 2012, the rates converged. Notably, during 2008 through 2012, incidence rates were significantly higher in black women compared with white women in 7 states, primarily located in the South. From 1989 to 2012, breast cancer death rates decreased by 36%, which translates to 249,000 breast cancer deaths averted in the United States over this period. This decrease in death rates was evident in all racial/ethnic groups except American Indians/Alaska Natives. However, the mortality disparity between black and white women nationwide has continued to widen; and, by 2012, death rates were 42% higher in black women than in white women. During 2003 through 2012, breast cancer death rates declined for white women in all 50 states; but, for black women, declines occurred in 27 of 30 states that had sufficient data to analyze trends. In 3 states (Mississippi, Oklahoma, and Wisconsin), breast cancer death rates in black women were stable during 2003 through 2012. Widening racial disparities in breast cancer mortality are likely to continue, at least in the short term, in view of the increasing trends in breast cancer incidence rates in black women. CA Cancer J Clin 2016;31–42. © 2015 American Cancer Society.     

Cancer Prevalence in Aichi,Japan for 2012: Estimates Based on Incidence and Survival Data from Population-Based Cancer Registry

Background: Cancer is the leading cause of death among both men and women in Japan. Monitoring cancer prevalence is important because prevalence data play a critical role in the development and implementation of health policy. We estimated cancer prevalence in 2012 based on cancer incidence and 5-year survival rate in Aichi Prefecture using data from a population-based cancer registry, the Aichi Cancer Registry, which covers 7.4 million people. Methods: The annual number of incident cases between 2008 and 2012 was used. Survival data of patients diagnosed in 2006–2008 and followed up until the end of 2012 were selected for survival analysis. Cancer prevalence was estimated from incidence and year-specific survival probabilities. Cancer prevalence was stratified by sex, cancer site (25 major cancers), and age group at diagnosis. Results: The estimated prevalence for all cancers in 2012 was 68,013 cases among men, 52,490 cases among women, with 120,503 cases for both sexes. Colorectal cancer was the most incident cancer with 6,654 cases, accounting for 16.0% of overall incident cases, followed by stomach cancer with 5,749 cases (13.8%) and lung cancer with 5,593 cases (13.4%). Prostate cancer was the most prevalent among men, accounting for 21.5%, followed by colorectal and stomach cancers. Breast cancer was the most prevalent among women, accounting for 28.6%, followed by colorectal, stomach, and uterine cancers. Conclusion: This study provides cancer prevalence data that could serve as useful essential information for local governments in cancer management, to carry out more practical and reasonable countermeasures for cancer.     

Persistent pain in anal cancer survivors

Introduction  Anorectal cancers are highly curable malignancies. Combined modality treatment with chemotherapy and radiation has dramatically improved both disease-free and overall survival. Little is known about symptomatic complications of treatment. Methods  Case report based on chart review. Results  Two patients presented with painful anal lesions that were diagnosed as squamous cell carcinoma of the anus. Despite successful treatment with chemotherapy and radiation, their pain syndromes worsened after treatment with development of a lumbosacral plexopathy that required regular followup, imaging, and pain medications. Conclusion  Pain syndromes may worsen after successful treatment given with curative intent, and may be a form of treatment toxicity. Implications for Cancer Survivors  Treatment related lumbosacral plexopathy may be an unrecognized consequence of the successful treatment of anal carcinoma. These symptoms can be controlled with analgesics.